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General NPI Number Information
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NPI Number | 1467779488
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Entity Type | Organization
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Legal Business Name | FAUSTO Q. AQUINO, JR.,M.D.,P.A.
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Dates
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Enumeration Date | 04/30/2010
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Last Update Date | 04/30/2010
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Provider Practice Location Address
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Address Line | 8713 HARFORD RD 101
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City | BALTIMORE
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State | MD
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Zip | 21234-4650
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Country | US
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Telephone | 410-665-1990
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Fax | 410-665-9980
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Provider Business Mailing Address
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Address Line | 8713 HARFORD RD 101
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City | BALTIMORE
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State | MD
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Zip | 21234-4650
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Country | US
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Telephone | 410-665-1990
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Fax | 410-665-9980
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FAUSTO QUIAMBAO AQUINO JR.
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Credential | M.D.
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Telephone | 410-665-1990
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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 | D014697
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License Number State | MD
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