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PATRICK ALBERTO LARREATEGUI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
3130 N COUNTY ROAD 25A, STE 214, TROY, OH 45373-1337
(937) 332-8777
(937) 332-8773
Mailing address
3130 N COUNTY ROAD 25A, STE 214, TROY, OH 45373-1337
(937) 332-8777
(937) 332-8773

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
34008069L
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0240840
MEDICARE GROUP #
OH
05
2500761
OH
01
MI9912194
MEDICARE GROUP #
Enumeration date
08/12/2005
Last updated
04/25/2017
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