Individual
JUAN L PESCHIERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
375 DIXMYTH AVE, CINCINNATI, OH 45220-2475
(513) 872-0669
Mailing address
PO BOX 710138, CINCINNATI, OH 45271-0001
Taxonomy
Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
Primary
35-051013
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000019740
ANTHEM BC BS
OH
05
—
0612251
—
OH
01
—
31145546100
WKERS COMP
OH
05
—
64865322
—
KY
01
—
720388
UNITED HEALTHCARE
OH
Enumeration date
12/21/2006
Last updated
03/05/2008
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