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NPI Code Detail

MEDICARE: DR. GUSTAVO DAVID AGUIRRE VMD, PHD

MEDICARE:  DR. GUSTAVO DAVID AGUIRRE  VMD, PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174M00000XVeterinarianBV003839LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10140565OTHERPAVETERINARIAN

General Provider Information

NPI Number : 1053660993
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GUSTAVO DAVID AGUIRRE VMD, PHD
Provider Business Mailing Address
First Line : 6419 OVERBROOK AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19151-2414
Country : US
Telephone Number : 215-879-2757
Fax Number :
Provider Business Practice Location Address
First Line : 6419 OVERBROOK AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19151-2414
Country : US
Telephone Number : 215-879-2757
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2012
Last Update Date : 09/06/2012

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Directions to “ DR. GUSTAVO DAVID AGUIRRE VMD, PHD” Practice Location

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