Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0106X | Orthopaedic Hand Surgeon | 28098 | MN |
Y | 2086S0105X | Surgery of the Hand | 28098 | MN |
NPI | 1467432997 |
---|---|
Provider Name | Peter Colby Amadio |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2006 |
Last Update Date | 11/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B77280 | (02) |