Provider Demographics
NPI:1982705125
Name:TOSI, FAIAOGA JR (MBBS, DIP SURG)
Entity Type:Individual
Prefix:DR
First Name:FAIAOGA
Middle Name:
Last Name:TOSI
Suffix:JR
Gender:M
Credentials:MBBS, DIP SURG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4564
Mailing Address - Street 2:
Mailing Address - City:PAGO PAGO
Mailing Address - State:AS
Mailing Address - Zip Code:96799-4564
Mailing Address - Country:US
Mailing Address - Phone:684-633-1222
Mailing Address - Fax:684-633-1839
Practice Address - Street 1:96799 TURNER DRIVE
Practice Address - Street 2:
Practice Address - City:PAGO PAGO
Practice Address - State:AS
Practice Address - Zip Code:96799-9994
Practice Address - Country:US
Practice Address - Phone:684-633-1222
Practice Address - Fax:684-633-1839
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2016-08-12
Deactivation Date:2007-07-17
Deactivation Code:
Reactivation Date:2016-08-12
Provider Licenses
StateLicense IDTaxonomies
AS2064A208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery