Provider Demographics
NPI:1669516183
Name:AYBAR, VICTOR R (DPM)
Entity type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:R
Last Name:AYBAR
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2963 MANCHESTER RD
Mailing Address - Street 2:STE D
Mailing Address - City:MANCHESTER
Mailing Address - State:MD
Mailing Address - Zip Code:21102-1853
Mailing Address - Country:US
Mailing Address - Phone:410-374-2229
Mailing Address - Fax:
Practice Address - Street 1:2963 MANCHESTER RD STE D
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:MD
Practice Address - Zip Code:21102
Practice Address - Country:US
Practice Address - Phone:410-374-2229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01134213EP1101X, 213ER0200X, 213ES0000X, 213ES0103X, 213ES0131X, 213E00000X, 213EP0504X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ER0200XPodiatric Medicine & Surgery Service ProvidersPodiatristRadiology
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
No213EP0504XPodiatric Medicine & Surgery Service ProvidersPodiatristPublic Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD52584001OtherCAREFIRST
MD958036OtherAETNA
MD759748701Medicaid
MDR2660001OtherBLUE CHOICE
MD2103244OtherOPTIMUM CHOICE
MDR2660001OtherBCBS FEDERAL
MD759748701Medicaid
MDU33906Medicare UPIN
MD958036OtherAETNA