Provider Demographics
NPI:1457383077
Name:MACHADO, EUGENIO (MD)
Entity Type:Individual
Prefix:
First Name:EUGENIO
Middle Name:
Last Name:MACHADO
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 1:5525 RESEARCH PARK DR FL 4
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4873
Mailing Address - Country:US
Mailing Address - Phone:301-572-8340
Mailing Address - Fax:301-572-8403
Practice Address - Street 1:3110 GRACEFIELD RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-1820
Practice Address - Country:US
Practice Address - Phone:301-572-8340
Practice Address - Fax:301-572-8403
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0024035207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD008203102Medicaid
MD340040-20OtherBCBS OF MD
DC0039OtherBCBS OF DC
MD04-05771OtherEVERCARE
0943ER-340040-02OtherCAREFIRST BCBS OF MD
34004002OtherBCBS
0943SE-340040-02OtherCAREFIRST BCBS OF MD
MD313841100Medicaid
9680-0025OtherCAREFIRST BCBS OF DC
MD04-05771OtherEVERCARE
MD340040-20OtherBCBS OF MD
0943ER-340040-02OtherCAREFIRST BCBS OF MD