Provider Demographics
NPI:1093927113
Name:PUGLIESE, MATTHEW SALVATORE (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:SALVATORE
Last Name:PUGLIESE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:747 BROADWAY
Mailing Address - Street 2:DEPARTMENT OF SURGICAL EDUCATION, 7 WEST
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122
Mailing Address - Country:US
Mailing Address - Phone:206-386-2123
Mailing Address - Fax:206-386-6293
Practice Address - Street 1:818 ST SEBASTIAN WAY
Practice Address - Street 2:STE 104
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901
Practice Address - Country:US
Practice Address - Phone:706-434-0130
Practice Address - Fax:706-434-0131
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2015-12-15
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Provider Licenses
StateLicense IDTaxonomies
GA0624172086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology