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Individual

JORGE B PISARELLO

Active
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Individual

JORGE B PISARELLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
58914
GA
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
MD027109E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1235131137
BCBSM - BLH
MI
05
1992795876
MI
01
58914
MEDICAL LICENSE
GA
Enumeration date
10/24/2005
Last updated
05/12/2015
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