Provider Demographics
NPI:1588819858
Name:ZULUAGA, ALVARO JOSE (MD)
Entity Type:Individual
Prefix:DR
First Name:ALVARO
Middle Name:JOSE
Last Name:ZULUAGA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ALVARO
Other - Middle Name:JOSE
Other - Last Name:ZULUAGA-GOMEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:811 WAVERLY RD
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-1452
Mailing Address - Country:US
Mailing Address - Phone:610-444-1679
Mailing Address - Fax:
Practice Address - Street 1:811 WAVERLY RD
Practice Address - Street 2:
Practice Address - City:KENNETT SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19348-1452
Practice Address - Country:US
Practice Address - Phone:610-444-1679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-29
Last Update Date:2008-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR171432085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology