Healthcare Provider Details

I. General information

NPI: 1316910011
Provider Name (Legal Business Name): JORGE C. SECADA-LOVIO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2006
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2206 WESTRIDGE RD
TIMONIUM MD
21093-3216
US

IV. Provider business mailing address

2206 WESTRIDGE RD
TIMONIUM MD
21093-3216
US

V. Phone/Fax

Practice location:
  • Phone: 410-591-8915
  • Fax:
Mailing address:
  • Phone: 410-591-8915
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberD22633
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: