Olazagasti, Juan C

Olazagasti, Juan C is an individual health care provider with primary practice located at 4348 Electric Rd , Roanoke VA 24018-0720. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Gastroenterology, which is considered as his primary health care specialty. Olazagasti, Juan C can be contacted via phone (540) 769-0976.

Contact Information

Primary practice address
4348 Electric Rd Roanoke VA 24018-0720
Phone: (540) 769-0976
Fax: (540) 857-5391
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Gastroenterology 2080P0206X ME0057738 Florida
Allopathic & Osteopathic Physicians / Pediatric Gastroenterology 2080P0206X 0101240810 Virginia

Profile Details

NPI number 1154430916
LBN Legal business name Olazagasti, Juan C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 29th, 2006
Last updated Aug 9th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154430916 NPPES
Virginia MEDICAID 010344701
Virginia MEDICAID 010383731
Virginia MEDICAID 55285201

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