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Individual

PAUL W. PUMILIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3124 S 19TH ST # 140, TACOMA, WA 98405-2433
(253) 459-6510
Mailing address
3124 S 19TH ST # 140, TACOMA, WA 98405-2433
(253) 459-6510

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2001-01597
NC
207R00000X
Internal Medicine Physician
Primary
MD6045014
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
04-00886
UNITED HEALTHCARE
NC
01
0637660001
PALMETTO GOV. BEN. SERVIC
NC
01
110228992
RAILROAD MEDICARE
NC
01
130K7
BLUE CROSS BLUE SHIELD
NC
01
561852981J
CIGNA
NC
05
89130K7
NC
Enumeration date
10/23/2006
Last updated
07/22/2014
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