Provider Demographics
NPI:1386751253
Name:PASTEUR, GEORGE JR (DPT)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:
Last Name:PASTEUR
Suffix:JR
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:174 WILLIS ST
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-5133
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:174 WILLIS ST
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5133
Practice Address - Country:US
Practice Address - Phone:240-372-0614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18685225100000X
VA2305204436225100000X
FLPT22353225100000X
DCPT870101225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDP00152495OtherRAILROAD MEDICARE
MD699702300Medicaid
DC00B386P12Medicare ID - Type Unspecified
FLU6849AMedicare ID - Type Unspecified
VA00W633P02Medicare ID - Type Unspecified
MDP00152495OtherRAILROAD MEDICARE