Provider Demographics
NPI:1376641563
Name:PUJARI, ASTRID MARIE (MD)
Entity Type:Individual
Prefix:
First Name:ASTRID
Middle Name:MARIE
Last Name:PUJARI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1370 STEWART ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98111
Mailing Address - Country:US
Mailing Address - Phone:206-344-8053
Mailing Address - Fax:206-344-7112
Practice Address - Street 1:1370 STEWART ST
Practice Address - Street 2:PUJARI CENTER
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101
Practice Address - Country:US
Practice Address - Phone:206-344-8053
Practice Address - Fax:206-344-7112
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00040267207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA6702PUOtherBLUE SHIELD VM
WA8291684Medicaid
AKMD3176WMedicaid
WAUS2578151OtherAETNA PCP PIN VM
WAUS2578155OtherAETNA SPECIALIST PIN VM
AKMD3176WMedicaid
WAUS2578155OtherAETNA SPECIALIST PIN VM
WA8853123Medicare PIN