Provider Demographics
NPI:1629185335
Name:AMATUZIO, JANIS CAROL (MD)
Entity Type:Individual
Prefix:
First Name:JANIS
Middle Name:CAROL
Last Name:AMATUZIO
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:3960 COON RAPIDS BLVD NW
Mailing Address - Street 2:
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55433-2569
Mailing Address - Country:US
Mailing Address - Phone:763-236-9050
Mailing Address - Fax:763-236-9051
Practice Address - Street 1:3960 COON RAPIDS BLVD NW
Practice Address - Street 2:
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433-2569
Practice Address - Country:US
Practice Address - Phone:763-236-9050
Practice Address - Fax:763-236-9051
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN23951207ZF0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology