Healthcare Provider Details

I. General information

NPI: 1730404153
Provider Name (Legal Business Name): ALFREDO B CARAGAY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2010
Last Update Date: 03/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 SAINT PAUL ST GROUND LEVEL
BALTIMORE MD
21202-2618
US

IV. Provider business mailing address

1120 SAINT PAUL ST GROUND LEVEL
BALTIMORE MD
21202-2618
US

V. Phone/Fax

Practice location:
  • Phone: 410-685-7790
  • Fax:
Mailing address:
  • Phone: 410-685-7790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberD0016332
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: