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1215929112

NPI Code Detail

MEDICARE: DR. PIO L. POBLETE M.D.

MEDICARE: DR. PIO L. POBLETE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	D0050338	MD

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110161664	OTHER	MD	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	543574-02	OTHER	MD	CAREFIRST MD RENDERING
3	029921	OTHER	MD	JHHC PROVIDER NUMBER
4	0568716	OTHER	MD	AETNA CAPITATED
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	P12724	OTHER	MD	CAREFIRST MPOS
7	5918117	OTHER	MD	AETNA FEE FOR SERVICE
8	860239	OTHER	MD	MAMSI PRIMARY CARE
9	3509-0009	OTHER	MD	CAREFIRST BLUECHOICE
10	260239	OTHER	MD	MAMSI SPECIALIST
11	3117511	OTHER	MD	CIGNA PIN

General Provider Information

NPI Number	:	1215929112
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PIO L. POBLETE M.D.

Provider Business Mailing Address
First Line	:	7580 BUCKINGHAM BLVD STE 220
Second Line	:
City	:	HANOVER
State	:	MD
Zip	:	21076-3210
Country	:	US
Telephone Number	:	410-729-5100
Fax Number	:

Provider Business Practice Location Address
First Line	:	5900 WATERLOO RD STE 200
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21045-2641
Country	:	US
Telephone Number	:	410-740-2900
Fax Number	:	410-992-0732

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2005
Last Update Date	:	03/16/2023

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Directions to “ DR. PIO L. POBLETE M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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