Provider Demographics
NPI:1700881539
Name:ARTURO BETANCOURT, M.D., P.A.
Entity Type:Organization
Organization Name:ARTURO BETANCOURT, M.D., P.A.
Other - Org Name:BALTIMORE WASHINGTON EYE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARTURO
Authorized Official - Middle Name:ESTEBAN
Authorized Official - Last Name:BETANCOURT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-766-3937
Mailing Address - Street 1:200 HOSPITAL DR
Mailing Address - Street 2:STE 600
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-5865
Mailing Address - Country:US
Mailing Address - Phone:410-766-3937
Mailing Address - Fax:410-761-4386
Practice Address - Street 1:200 HOSPITAL DR
Practice Address - Street 2:STE 600
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-5865
Practice Address - Country:US
Practice Address - Phone:410-766-3937
Practice Address - Fax:410-761-4386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-17
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA1009261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD757461400Medicaid
MD490004147OtherRAILROAD MEDICARE
MDZZ92BAMedicare PIN