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General NPI Number Information
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NPI Number | 1003112210
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Entity Type | Individual
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Provider Name | INES MARIA VIGIL MD, MPH, MBA
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Gender | Female
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Dates
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Enumeration Date | 02/04/2011
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Last Update Date | 02/04/2011
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Provider Practice Location Address
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Address Line | 6701 CURTIS CT
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City | GLEN BURNIE
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State | MD
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Zip | 21060-6405
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Country | US
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Telephone | 443-845-2816
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Fax |
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Provider Business Mailing Address
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Address Line | 6701 CURTIS CT
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City | GLEN BURNIE
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State | MD
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Zip | 21060-6405
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Country | US
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Telephone | 443-845-2816
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | D0068184
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 4301093338
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License Number State | MI
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