Provider Demographics
NPI:1447573480
Name:JOSELITO D. MAGDAY, MD PA
Entity Type:Organization
Organization Name:JOSELITO D. MAGDAY, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSELITO
Authorized Official - Middle Name:DURAN
Authorized Official - Last Name:MAGDAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-937-5452
Mailing Address - Street 1:11701 ROBY AVE
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-1509
Mailing Address - Country:US
Mailing Address - Phone:301-937-5452
Mailing Address - Fax:
Practice Address - Street 1:11701 ROBY AVE
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-1509
Practice Address - Country:US
Practice Address - Phone:301-937-5452
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-04
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0013687261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD016981100Medicaid
MD161622Medicare PIN
MD016981100Medicaid