Provider Demographics
NPI:1619958832
Name:PAGLINAUAN, TEODULO JASON JR (MD)
Entity Type:Individual
Prefix:DR
First Name:TEODULO
Middle Name:JASON
Last Name:PAGLINAUAN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:617 STEMMERS RUN RD
Mailing Address - Street 2:STE E
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21221-3334
Mailing Address - Country:US
Mailing Address - Phone:410-687-8818
Mailing Address - Fax:410-682-3989
Practice Address - Street 1:617 STEMMERS RUN RD
Practice Address - Street 2:STE E
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21221-3334
Practice Address - Country:US
Practice Address - Phone:410-687-8818
Practice Address - Fax:410-682-3989
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD00015022207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD819MMedicare ID - Type Unspecified
C49283Medicare UPIN