Healthcare Provider Details

I. General information

NPI: 1326256256
Provider Name (Legal Business Name): PEDRO C ANLOAGUE, JR.,M.D.,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 02/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 JOHN GLENN DR
SEVEN HILLS OH
44131-2930
US

IV. Provider business mailing address

1200 JOHN GLENN DR
SEVEN HILLS OH
44131-2930
US

V. Phone/Fax

Practice location:
  • Phone: 216-338-7796
  • Fax: 216-265-3609
Mailing address:
  • Phone: 216-338-7796
  • Fax: 216-265-3609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number35035322
License Number StateOH

VIII. Authorized Official

Name: DR. PEDRO CREER ANLOAGUE JR.
Title or Position: OWNER
Credential: M.D.
Phone: 216-338-7796