Provider Demographics
NPI:1326256256
Name:PEDRO C ANLOAGUE, JR.,M.D.,INC
Entity Type:Organization
Organization Name:PEDRO C ANLOAGUE, JR.,M.D.,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:CREER
Authorized Official - Last Name:ANLOAGUE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:216-338-7796
Mailing Address - Street 1:1200 JOHN GLENN DR
Mailing Address - Street 2:
Mailing Address - City:SEVEN HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44131-2930
Mailing Address - Country:US
Mailing Address - Phone:216-338-7796
Mailing Address - Fax:216-265-3609
Practice Address - Street 1:1200 JOHN GLENN DR
Practice Address - Street 2:
Practice Address - City:SEVEN HILLS
Practice Address - State:OH
Practice Address - Zip Code:44131-2930
Practice Address - Country:US
Practice Address - Phone:216-338-7796
Practice Address - Fax:216-265-3609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35035322207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2746916Medicaid
OH9369291Medicare PIN