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General NPI Number Information
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NPI Number | 1942309810
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Entity Type | Individual
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Provider Name | EDUARDO RODRIGUEZ DE LA CRUZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 08/01/2018
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Provider Practice Location Address
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Address Line | 125 PERSIMMON CIR
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City | REISTERSTOWN
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State | MD
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Zip | 21136
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Country | US
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Telephone | 410-596-7591
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Fax |
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Provider Business Mailing Address
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Address Line | 9409 HIGH ROCK WAY
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City | OWINGS MILLS
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State | MD
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Zip | 21117
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Country | US
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Telephone | 410-596-7591
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Fax | 410-549-8055
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 50366
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD-17810
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License Number State | HI
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | D29531
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License Number State | MD
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