Healthcare Provider Details

I. General information

NPI: 1073619375
Provider Name (Legal Business Name): EDWIN FRANCISCO AGUILAR LOPEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6830 HOSPITAL DR SUITE 206
BALTIMORE MD
21237-4373
US

IV. Provider business mailing address

6830 HOSPITAL DR SUITE 206
BALTIMORE MD
21237-4373
US

V. Phone/Fax

Practice location:
  • Phone: 410-238-5390
  • Fax: 410-238-5396
Mailing address:
  • Phone: 410-238-5390
  • Fax: 410-238-5396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0063446
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: