Individual
DR. JORGE GUSTAVO PARDES
Active
Individual
DR. JORGE GUSTAVO PARDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
25MA08326800
NJ
2085R0202X
Diagnostic Radiology Physician
MD049953L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014226300005
—
PA
05
—
0149420
—
NJ
05
—
0844459
—
PA
01
—
483261
PA BLUE SHIELD
PA
Enumeration date
10/07/2005
Last updated
10/14/2011
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