Pastrana, Enrique
Pastrana, Enrique is an individual health care provider with primary practice located at 1011 Bowles Ave. Suite 300, Fenton MO 63026-2387. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Pastrana, Enrique can be contacted via phone (636) 496-5030.Contact Information
Primary practice address
1011 Bowles Ave. Suite 300
Fenton MO 63026-2387
Phone: (636) 496-5030
Fax: (636) 496-5035
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | R1P02 | Missouri |
Profile Details
| NPI number | 1417940412 |
|---|---|
| LBN Legal business name | Pastrana, Enrique |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 24th, 2005 |
| Last updated | Jun 8th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417940412 | NPPES |
| Missouri | MEDICAID | 208176503 |
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