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NPI Code Detail

MEDICARE: JAMES MICHAEL PACENTA MD

MEDICARE: JAMES MICHAEL PACENTA MD
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
1207RC0000XCardiovascular Disease Physician35051955OH
2207RI0011XInterventional Cardiology Physician35.051955OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2000000005802OTHEROHANTHEM

General Provider Information

NPI Number : 1558360016
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES MICHAEL PACENTA MD
Provider Business Mailing Address
First Line : 122 WYOMING ST
Second Line :
City : DAYTON
State : OH
Zip : 45409-2731
Country : US
Telephone Number : 937-223-4461
Fax Number : 937-224-1945
Provider Business Practice Location Address
First Line : 122 WYOMING ST
Second Line :
City : DAYTON
State : OH
Zip : 45409-2731
Country : US
Telephone Number : 937-223-4461
Fax Number : 937-224-1945
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2005
Last Update Date : 02/02/2017

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Directions to “ JAMES MICHAEL PACENTA MD” Practice Location

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