Provider Demographics
NPI:1770581613
Name:ALEGADO, ROLANDO BALADAD (MD PA)
Entity type:Individual
Prefix:MR
First Name:ROLANDO
Middle Name:BALADAD
Last Name:ALEGADO
Suffix:
Gender:M
Credentials:MD PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 630015
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21263-0015
Mailing Address - Country:US
Mailing Address - Phone:410-354-2233
Mailing Address - Fax:410-354-1544
Practice Address - Street 1:3001 S HANOVER ST
Practice Address - Street 2:SUITE 201
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21225-1233
Practice Address - Country:US
Practice Address - Phone:410-354-2233
Practice Address - Fax:410-354-1544
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-13
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD21628207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KT92KOOtherBSMD
4139576OtherAETNA
MD148L995AMedicare PIN
4139576OtherAETNA