Provider Demographics
NPI:1689674061
Name:ALBERT FOLGUERAS MD PA
Entity Type:Organization
Organization Name:ALBERT FOLGUERAS MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:FOLGUERAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-788-4250
Mailing Address - Street 1:413 COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-3044
Mailing Address - Country:US
Mailing Address - Phone:410-788-4250
Mailing Address - Fax:410-788-9324
Practice Address - Street 1:413 COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21228-3044
Practice Address - Country:US
Practice Address - Phone:410-788-4250
Practice Address - Fax:410-788-9324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-28
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0044113207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD149661100Medicaid
MD149661100Medicaid