Provider Demographics
NPI:1598838104
Name:ARTURO BETANCOURT, M.D., P.A.
Entity Type:Organization
Organization Name:ARTURO BETANCOURT, M.D., P.A.
Other - Org Name:BALTIMORE WASHINGTON EYE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARTURO
Authorized Official - Middle Name:ESTEBAN
Authorized Official - Last Name:BETANCOURT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-766-3937
Mailing Address - Street 1:6100 DAYLONG LN
Mailing Address - Street 2:SUITE 207
Mailing Address - City:CLARKSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21029-1626
Mailing Address - Country:US
Mailing Address - Phone:410-537-2208
Mailing Address - Fax:410-531-7717
Practice Address - Street 1:200 HOSPITAL DR STE 600
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-5865
Practice Address - Country:US
Practice Address - Phone:410-766-3937
Practice Address - Fax:410-531-7717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD605221500Medicaid