Individual
MAURICIO JOSE PASQUALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
304A E 4TH ST, ELDON, MO 65026-1808
(573) 557-2400
(573) 557-2401
Mailing address
54 HOSPITAL DR, OSAGE BEACH, MO 65065-3050
(573) 348-8000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2018004251
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
220051618
—
MO
Enumeration date
12/28/2010
Last updated
04/07/2023
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