Provider Demographics
NPI:1619032554
Name:AMAO, CAROLINE M (MD)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:M
Last Name:AMAO
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 1:603 ROSARY DR
Mailing Address - Street 2:
Mailing Address - City:CORNING
Mailing Address - State:IA
Mailing Address - Zip Code:50841-1683
Mailing Address - Country:US
Mailing Address - Phone:641-322-3121
Mailing Address - Fax:
Practice Address - Street 1:603 ROSARY DR
Practice Address - Street 2:
Practice Address - City:CORNING
Practice Address - State:IA
Practice Address - Zip Code:50841-1683
Practice Address - Country:US
Practice Address - Phone:641-322-3121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA35948207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine