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Individual

PEDRO C PADILLA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD PC

Contact information

Practice address
20 MANOR DR, TROY, MO 63379-0267
(636) 528-6844
(636) 462-2809
Mailing address
20 MANOR DR, PO BOX 267, TROY, MO 63379-2044
(636) 528-6844
(636) 462-2809

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
35762
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000317
NHC BENEFIT
01
101073
HEALTHLINK
01
11548
ESSENCE
01
12076745
MULTI-PLAN
01
12731
GROUP HEALTH PLAN
05
201214509
MO
01
25125
CARPENTERS
01
412131784
COMMERCIAL
01
4397518
AETNA
01
4906THFR
BLUE SHIELD KC
01
7896
BLUE SHIELD
01
826343353A
RAILROAD
01
A90852
MERCY
01
BLC0071180001
BLUE CHOICE
01
BLC007118002
BLUE CHOICE
Enumeration date
09/12/2005
Last updated
10/19/2011
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