Provider Demographics
NPI:1598176695
Name:NUAMAH, LIVINGSTON (DPM)
Entity Type:Individual
Prefix:
First Name:LIVINGSTON
Middle Name:
Last Name:NUAMAH
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2441 US HIGHWAY 98 W
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SANTA ROSA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32459-5385
Mailing Address - Country:US
Mailing Address - Phone:850-267-4554
Mailing Address - Fax:
Practice Address - Street 1:2441 US HIGHWAY 98 W
Practice Address - Street 2:SUITE 102
Practice Address - City:SANTA ROSA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32459-5385
Practice Address - Country:US
Practice Address - Phone:850-267-4554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-13
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2577213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL65625Medicare PIN
FLU78326Medicare UPIN