Provider Demographics
NPI:1801893359
Name:MUNSON, AMADO RAMOS (PA)
Entity type:Individual
Prefix:
First Name:AMADO
Middle Name:RAMOS
Last Name:MUNSON
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:100 WASON AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01107-1381
Mailing Address - Country:US
Mailing Address - Phone:413-241-2100
Mailing Address - Fax:413-241-2100
Practice Address - Street 1:100 WASON AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1381
Practice Address - Country:US
Practice Address - Phone:413-241-2100
Practice Address - Fax:413-735-1982
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA446363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0604117OtherUNITED HEALTHCARE DIRECT
MA105746700OtherUS DEPT OF LABOR/W/C
MA970011261OtherRAILROAD MEDICARE
MAJ08850OtherBLUE SHIELD OF MA
MA751015OtherSECURE HORIZONS
MA000446OtherCONNECTICARE
MA3053245Medicaid
MA751015OtherTUFTS
MAMA0025741OtherFEDERAL HEALTHNET
MA13522OtherHEALTH NEW ENGLAND
MAS31461Medicare UPIN
MA751015OtherSECURE HORIZONS