Provider Demographics
NPI:1861162752
Name:PAGAN MONSEGUR MD SERVICES PSC
Entity type:Organization
Organization Name:PAGAN MONSEGUR MD SERVICES PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WENDEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-907-3891
Mailing Address - Street 1:#63 CALLE VIRGINIA
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680-3820
Mailing Address - Country:US
Mailing Address - Phone:787-833-0828
Mailing Address - Fax:
Practice Address - Street 1:#63 CALLE VIRGINIA
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-3820
Practice Address - Country:US
Practice Address - Phone:787-833-0828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PAGAN MONSEGUR MD SERVICES PSC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRJM264Medicaid