Provider Demographics
NPI:1033145321
Name:ESPINOZA, ALIDA MERCEDES (MD)
Entity Type:Individual
Prefix:DR
First Name:ALIDA
Middle Name:MERCEDES
Last Name:ESPINOZA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ALIDA
Other - Middle Name:MERCEDES
Other - Last Name:ANDRIOLLO-ESPINOZA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:6928 SANDY CREEK CT
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21029-1747
Mailing Address - Country:US
Mailing Address - Phone:443-535-8699
Mailing Address - Fax:
Practice Address - Street 1:1130 OPAL CT
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5940
Practice Address - Country:US
Practice Address - Phone:301-797-8279
Practice Address - Fax:301-797-8504
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0062607207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology