Provider Demographics
NPI:1003112210
Name:VIGIL, INES MARIA (MD, MPH, MBA)
Entity Type:Individual
Prefix:DR
First Name:INES
Middle Name:MARIA
Last Name:VIGIL
Suffix:
Gender:F
Credentials:MD, MPH, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6701 CURTIS CT
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21060-6405
Mailing Address - Country:US
Mailing Address - Phone:443-845-2816
Mailing Address - Fax:
Practice Address - Street 1:6701 CURTIS CT
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21060-6405
Practice Address - Country:US
Practice Address - Phone:443-845-2816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-04
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0068184261QP2300X
MI4301093338261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care