Provider Demographics
NPI:1871096313
Name:POGUE, PATRICK (MED)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:POGUE
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 CHELTON CIR
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-8477
Mailing Address - Country:US
Mailing Address - Phone:267-650-5124
Mailing Address - Fax:
Practice Address - Street 1:14 CHELTON CIR
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-8477
Practice Address - Country:US
Practice Address - Phone:267-650-5124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-12
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor