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General NPI Number Information
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NPI Number | 1922110642
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Entity Type | Organization
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Legal Business Name | ST MARYS MEDICAL GROUP INC.
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 1132 HAGER ST
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City | SAINT MARYS
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State | OH
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Zip | 45885-2423
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Country | US
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Telephone | 419-394-5851
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Fax | 419-394-0702
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Provider Business Mailing Address
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Address Line | 1132 HAGER ST
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City | SAINT MARYS
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State | OH
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Zip | 45885-2423
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Country | US
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Telephone | 419-394-5851
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Fax | 419-394-0702
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALFREDO A PAGUIRIGAN
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Credential | M.D.
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Telephone | 419-394-5851
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35-032121P
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License Number State | OH
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