Provider Demographics
NPI:1972608933
Name:ABREGO-GARCIA, JORGE HORACIO (MD)
Entity Type:Individual
Prefix:DR
First Name:JORGE
Middle Name:HORACIO
Last Name:ABREGO-GARCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JORGE
Other - Middle Name:H
Other - Last Name:ABREGO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:5564 MARLAN DR
Mailing Address - Street 2:
Mailing Address - City:TRAPPE
Mailing Address - State:MD
Mailing Address - Zip Code:21673-1908
Mailing Address - Country:US
Mailing Address - Phone:410-476-9798
Mailing Address - Fax:
Practice Address - Street 1:598 CYNWOOD DR
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-3805
Practice Address - Country:US
Practice Address - Phone:410-820-5755
Practice Address - Fax:410-820-0525
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0051132207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD153500500Medicaid
MD945RMedicare ID - Type Unspecified