Individual
JAIME M PUA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1805 27TH ST, PORTSMOUTH, OH 45662-2640
(740) 356-5000
Mailing address
255 BARKS RD E, MARION, OH 43302-6425
(740) 389-2840
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
35036311
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000204164
BCBS
OH
05
—
0231752
—
OH
05
—
64030463
—
KY
Enumeration date
05/27/2006
Last updated
07/08/2007
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