Provider Demographics
NPI:1962462432
Name:ESPINOSA, BIALINES A (MD)
Entity Type:Individual
Prefix:
First Name:BIALINES
Middle Name:A
Last Name:ESPINOSA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8239 MEADOWBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-2329
Mailing Address - Country:US
Mailing Address - Phone:804-730-0800
Mailing Address - Fax:804-730-0839
Practice Address - Street 1:8239 MEADOWBRIDGE RD
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-2329
Practice Address - Country:US
Practice Address - Phone:804-730-0800
Practice Address - Fax:804-730-0839
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101235023174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA02238420Medicaid