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General NPI Number Information
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NPI Number | 1366611071
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Entity Type | Organization
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Legal Business Name | HARMAR VILLAGE MEDICAL INC
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Dates
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Enumeration Date | 02/27/2008
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Last Update Date | 05/20/2008
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Provider Practice Location Address
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Address Line | 119 MAPLE STREET
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City | MARIETTA
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State | OH
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Zip | 45750
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Country | US
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Telephone | 740-376-1520
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Fax | 740-376-1525
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Provider Business Mailing Address
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Address Line | 119 MAPLE STREET
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City | MARIETTA
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State | OH
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Zip | 45750
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Country | US
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Telephone | 740-376-1520
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Fax | 740-376-1525
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Authorized Official
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Title or Position | PRESIDENT
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Name | PEDRITO APOONG GALUPO
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Credential | MD
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Telephone | 740-376-1520
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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