Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 062417 | GA |
NPI | 1093927113 |
---|---|
Provider Name | Dr. Matthew Salvatore Pugliese |
First Address | Seattle, WA 98122 |
Second Address | Augusta, GA 30901 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2007 |
Last Update Date | 15/12/2015 |