Healthcare Provider Details

I. General information

NPI: 1457356271
Provider Name (Legal Business Name): ARTURO ESTEBAN BETANCOURT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2005
Last Update Date: 03/06/2023
Certification Date: 03/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HOSPITAL DR STE 600
GLEN BURNIE MD
21061-5865
US

IV. Provider business mailing address

200 HOSPITAL DR STE 600
GLEN BURNIE MD
21061-5865
US

V. Phone/Fax

Practice location:
  • Phone: 410-766-3937
  • Fax: 410-761-4386
Mailing address:
  • Phone: 410-766-3937
  • Fax: 410-761-4386

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberD0036550
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: