1427057280 NPI number — HELENA DUQUE-PAGES MD

Table of content: HELENA DUQUE-PAGES MD (NPI 1427057280)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427057280 NPI number — HELENA DUQUE-PAGES MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DUQUE-PAGES
Provider First Name:
HELENA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427057280
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/12/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1157 N MONROE DR
Provider Second Line Business Mailing Address:
STE. 210
Provider Business Mailing Address City Name:
XENIA
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45385-1697
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
937-374-4042
Provider Business Mailing Address Fax Number:
937-374-4031

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1157 N MONROE DR
Provider Second Line Business Practice Location Address:
STE. 210
Provider Business Practice Location Address City Name:
XENIA
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45385-1697
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
937-374-4042
Provider Business Practice Location Address Fax Number:
937-374-4031
Provider Enumeration Date:
07/14/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  35063697 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000012092 . This is a "ANTHEM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 000000529205 . This is a "ANTHEM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0884333 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00432939 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 080079616 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com