Provider Demographics
NPI:1780775247
Name:PASCUAL, VIRGINIA (MD)
Entity type:Individual
Prefix:DR
First Name:VIRGINIA
Middle Name:
Last Name:PASCUAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1408 KILRUSH DR
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-2882
Mailing Address - Country:US
Mailing Address - Phone:406-495-7265
Mailing Address - Fax:406-443-4526
Practice Address - Street 1:212 GA HIGHWAY 49 N STE 1900
Practice Address - Street 2:
Practice Address - City:BYRON
Practice Address - State:GA
Practice Address - Zip Code:31008-4059
Practice Address - Country:US
Practice Address - Phone:478-238-3552
Practice Address - Fax:478-259-6170
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2025-01-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MT7919207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0024191Medicaid
WY1193597Medicaid
MT13771OtherBLUE CROSS
WY1193597Medicaid