1679508972 NPI number — DR. MICHAEL AMATO DC

Table of content: DR. MICHAEL AMATO DC (NPI 1679508972)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679508972 NPI number — DR. MICHAEL AMATO DC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AMATO
Provider First Name:
MICHAEL
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1679508972
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/07/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 284
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEST WAREHAM
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02576-0284
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-273-0190
Provider Business Mailing Address Fax Number:
508-273-9943

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2360 CRANBERRY HWY
Provider Second Line Business Practice Location Address:
UNIT 6
Provider Business Practice Location Address City Name:
WEST WAREHAM
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02576-1208
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-273-0190
Provider Business Practice Location Address Fax Number:
508-273-0190
Provider Enumeration Date:
07/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  2195 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3087869 . This is a "AETNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: AA45347 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 4400507 . This is a "UNITED HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: B20757101 . This is a "CIGNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1612727 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: Y36566 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".




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