Provider Demographics
NPI:1366468845
Name:HIDALGO, HECTOR J (MD)
Entity Type:Individual
Prefix:
First Name:HECTOR
Middle Name:J
Last Name:HIDALGO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4020 WESTCHASE BLVD
Mailing Address - Street 2:SUITE 390
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-3938
Mailing Address - Country:US
Mailing Address - Phone:919-834-2767
Mailing Address - Fax:919-834-0234
Practice Address - Street 1:3643 N ROXBORO ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-2702
Practice Address - Country:US
Practice Address - Phone:919-470-5272
Practice Address - Fax:919-470-5271
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC244142085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8942361Medicaid
C88383Medicare UPIN
NC8942361Medicaid