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Individual

DR. MINI PETERSON PATHROSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
903 NW WASHINGTON BLVD, SUITE B, HAMILTON, OH 45013-6386
(513) 867-9000
(513) 785-3675
Mailing address
903 NW WASHINGTON BLVD, STE. B, HAMILTON, OH 45013-6386
(513) 867-9000
(513) 785-3675

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35080562P
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2357417
OH
Enumeration date
07/19/2005
Last updated
11/14/2011
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