Individual
JOHN VINCENT PASTORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-1009
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
223318
NY
208000000X
Pediatrics Physician
Primary
87253
SC
208M00000X
Hospitalist Physician
87253
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00026960701
UNIVERA
—
01
—
000528058001
BC/BS
—
01
—
000528058003
BC/BS
—
05
—
02414482
—
NY
01
—
050301000096
FIDELIS
—
01
—
051021000000
FIDELIS
—
01
—
1212816
IHA
—
Enumeration date
05/15/2006
Last updated
11/03/2025
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