1457383077 NPI number — EUGENIO MACHADO M.D.

Table of content: EUGENIO MACHADO M.D. (NPI 1457383077)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457383077 NPI number — EUGENIO MACHADO M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MACHADO
Provider First Name:
EUGENIO
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457383077
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/09/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5525 RESEARCH PARK DR FL 4
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21228-4873
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-572-8340
Provider Business Mailing Address Fax Number:
301-572-8403

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3110 GRACEFIELD RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SILVER SPRING
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20904-1820
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-572-8340
Provider Business Practice Location Address Fax Number:
301-572-8403
Provider Enumeration Date:
07/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  D0024035 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 008203102 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 340040-20 . This is a "BCBS OF MD" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 0039 . This is a "BCBS OF DC" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 04-05771 . This is a "EVERCARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 0943ER-340040-02 . This is a "CAREFIRST BCBS OF MD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 34004002 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0943SE-340040-02 . This is a "CAREFIRST BCBS OF MD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 313841100 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9680-0025 . This is a "CAREFIRST BCBS OF DC" identifier . This identifiers is of the category "OTHER".




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