Basic Information
Provider Information
NPI: 1669679064
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PAGAR
FirstName: JOSHUA
MiddleName: SCOTT
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 HOSPITAL DR
Address2: DC018.00, MA202F
City: COLUMBIA
State: MO
PostalCode: 652120001
CountryCode: US
TelephoneNumber: 5738828885
FaxNumber: 5738844808
Practice Location
Address1: 1 HOSPITAL DR
Address2: DC018.00, MA202F
City: COLUMBIA
State: MO
PostalCode: 652120001
CountryCode: US
TelephoneNumber: 5738828885
FaxNumber: 5738844808
Other Information
ProviderEnumerationDate: 06/28/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208800000X2007018520MOY Allopathic & Osteopathic PhysiciansUrology 

No ID Information.


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