Doctor Name: | DR. AUGUSTO PENALES RODRIGUEZ |
NPI Number: | 1952647752 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | D21230 |
Business Practice Address: | 5009 Rayburn Ct Camp Springs, MD - 207482230 |
Business Phone Number: | 3014231683 |
Business Fax Number: | 3014231683 |
Mailing Address: | 5009 Rayburn Ct, CAMP SPRINGS |
State: | MD |
Postal Code: | 207482230 |
Phone Number: | 3014231683 |
Fax Number: | 3014231683 |
NPI Enumeration Date: | 12/25/2012 |
NPI Last Update Date: | 12/25/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | D21230 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |