Healthcare Provider Details

I. General information

NPI: 1295674240
Provider Name (Legal Business Name): JOSE PABLO ARAYA QUEZADA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N. WOLFE STREET, MEYER 8-181
BALTIMORE MD
21287
US

IV. Provider business mailing address

600 N. WOLFE STREET, MEYER 8-181
BALTIMORE MD
21287
US

V. Phone/Fax

Practice location:
  • Phone: 443-287-1609
  • Fax: 443-287-8044
Mailing address:
  • Phone: 443-287-1609
  • Fax: 443-287-8044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: