Provider Demographics
NPI:1336348697
Name:GARCIA HRUBY, IDALINA (MD)
Entity Type:Individual
Prefix:DR
First Name:IDALINA
Middle Name:
Last Name:GARCIA HRUBY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:IDALINA
Other - Middle Name:
Other - Last Name:GARCIA JAVIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 603949
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-3949
Mailing Address - Country:US
Mailing Address - Phone:919-350-0351
Mailing Address - Fax:919-350-7687
Practice Address - Street 1:3000 NEW BERN AVE
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1231
Practice Address - Country:US
Practice Address - Phone:919-350-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2010-01811208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0691974OtherCIGNA
WV3810010600Medicaid
MD914194-01OtherCAREFIRST BCBS
MD413362500Medicaid
9853062OtherAETNA
NC1336348697Medicaid
MDP17775OtherBCBS
W399-0011OtherBCBS GHMSI
520896782001OtherHEALTHNET
9495094OtherMULTI PLAN PHCS
P00447458OtherRAILROAD MEDICARE