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Organization

PASTOR MEDICAL GROUP DOCTORS FOR ADULTS INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SILVIA ELIZABETH PASTOR-ITURRICHA MD (PRESIDENT)
(513) 939-0333
Entity
Organization

Contact information

Practice address
5966 BOYMEL DR, UNIT 1, FAIRFIELD, OH 45014
(513) 939-0333
(513) 939-0444
Mailing address
PO BOX 691924, CINCINNATI, OH 45269-1924
(513) 939-0333

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2490906
OH
01
DA5113
RR MEDICARE
OH
Enumeration date
06/01/2006
Last updated
04/17/2008
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