Provider Demographics
NPI:1366480972
Name:BENALCAZAR, HUGO ERMEL (MD)
Entity Type:Individual
Prefix:DR
First Name:HUGO
Middle Name:ERMEL
Last Name:BENALCAZAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 S HAYS ST
Mailing Address - Street 2:BRAIN & SPINE SPECIALISTS
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-3672
Mailing Address - Country:US
Mailing Address - Phone:410-515-1515
Mailing Address - Fax:410-900-1901
Practice Address - Street 1:206 S HAYS ST
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-3672
Practice Address - Country:US
Practice Address - Phone:410-515-1515
Practice Address - Fax:410-900-1901
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0056356207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
H25406Medicare UPIN
MD594MMedicare PIN
MD6000190001Medicare NSC
MD5521770001Medicare NSC
MD472PMedicare PIN