Provider Demographics
NPI:1417225319
Name:LOARTE CAMPOS, PABLO (MD)
Entity Type:Individual
Prefix:DR
First Name:PABLO
Middle Name:
Last Name:LOARTE CAMPOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:111 E 210TH ST FL C2
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-2401
Mailing Address - Country:US
Mailing Address - Phone:718-920-5968
Mailing Address - Fax:718-547-4773
Practice Address - Street 1:111 E 210TH ST FL C2
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2401
Practice Address - Country:US
Practice Address - Phone:718-920-5968
Practice Address - Fax:718-547-4773
Is Sole Proprietor?:No
Enumeration Date:2011-12-06
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT53235208M00000X
AZ56545207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist