DR. MD Edmundo Samuel Justino, NPI 1720156136
Gastroenterology Physician in Prescott, AZ, US
NPI number: what is it?
The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...
| NPI | 1720156136 |
| NPI Entity Type | Individual |
| Provider Name | DR. MD Edmundo Samuel Justino |
| Enumeration Date | September 30, 2009 |
| Last Update Date | September 30, 2009 |
| Certification Date | September 30, 2009 |
| Provider Location Address | 810 Ainsworth Dr Ste A, Prescott, AZ, US |
| Provider Mailing Address | Po Box 10880, Prescott, AZ, US, 863040880 |
| Gender | Male |
| Is Sole Proprietor? | No |
Primary Taxonomy
| Taxonomy Code | |
| Taxonomy Name | Gastroenterology Physician |
| Classification | |
| Group | |
| License No. | 60368 |
| License State | AZ |
| Description | An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
Secondary Taxonomies
| Taxonomy Code | Group | Classification | License No. | State | Primary? |
|---|---|---|---|---|---|
| 11931 | ND | No |
Other Identifiers
| Identifier | Identifier State | Identifier Issuer | Type/Code |
|---|---|---|---|
| TXB107550 | TX | MEDICARE PTAN | 01 |
| 60368 | AZ | MEDICAL LICENSE | 01 |
| 007145 | AZ | MEDICAID | 05 |
| 215032801 | TX | MEDICAID | 05 |
| FJ9217933 | US DEPT OF JUSTICE - DRUG ENFORCEMENT ADMIN | 01 |
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