Individual
ANTOINETTE A PRAGALOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35-06-7070
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000565730
ANTHEM PIN
—
05
—
0249412
—
OH
01
—
P00685499
RAIL ROAD MEDICARE
—
Enumeration date
08/11/2005
Last updated
07/16/2021
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