MEDICARE: LAURA ELLEN AMSINK M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	0101054484	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	080137873	OTHER	VA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	226498	OTHER	VA	ANTHEM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861498545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA ELLEN AMSINK M.D.

Provider Business Mailing Address
First Line	:	UNIT 33100
Second Line	:
City	:	APO
State	:	AE
Zip	:	09180-3100
Country	:	US
Telephone Number	:	314-590-8567
Fax Number	:

Provider Business Practice Location Address
First Line	:	UNIT 33100 BOX CMR402
Second Line	:
City	:	APO
State	:	AE
Zip	:	09180-3100
Country	:	US
Telephone Number	:	314-590-8567
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2005
Last Update Date	:	09/26/2022

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