MRS. AMANDA ROSE PUNG PA C NPI 1699844571

NPI Information

NPI: 1699844571
Provider Name: MRS. AMANDA ROSE PUNG, PA C
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

PECOS Registration: Yes

Address:
319 W DELAWARE ST
DECATUR, MI
ZIP 49045
Phone: (269) 423-7028
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MRS. Amanda Rose Pung, PA C is a surgical physician assistant in Decatur, MI with 18 years of experience. MRS. Amanda Rose Pung, PA C NPI is 1699844571. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

319 W DELAWARE ST
DECATUR, MI
ZIP 49045-106
Phone: (269) 423-7028
Fax: (269) 423-8282

The NPI 1699844571 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/7/2006 and was last updated on 11/27/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AS0400X	Physician Assistant	Surgical	5601004946	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	5390069	OTHER	MICHIGAN	BCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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