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NPI Code Detail

MEDICARE: ROGER G AMIGO D.O.

MEDICARE: ROGER G AMIGO D.O.
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
1208800000XUrology Physician5016OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1340010844OTHEROHRAILROAD MEDICARE PALMETT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2000000007681OTHEROHANTHAN BCBS
3310884319033OTHEROHCARESOURCE
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
55198086OTHEROHAETNA
63980672OTHEROHCIGNA

General Provider Information

NPI Number : 1982603668
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROGER G AMIGO D.O.
Provider Business Mailing Address
First Line : 2160 EWING CRAWFIS CIR
Second Line :
City : BELLEFONTAINE
State : OH
Zip : 43311-9042
Country : US
Telephone Number : 937-593-0070
Fax Number : 937-599-0075
Provider Business Practice Location Address
First Line : 2160 EWING CRAWFIS CIR
Second Line :
City : BELLEFONTAINE
State : OH
Zip : 43311-9042
Country : US
Telephone Number : 937-593-0070
Fax Number : 937-599-0075
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2005
Last Update Date : 11/18/2016

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Directions to “ ROGER G AMIGO D.O.” Practice Location

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