Provider Demographics
NPI:1952592818
Name:DAPUL-HIDALGO, GINA E (MD)
Entity type:Individual
Prefix:DR
First Name:GINA
Middle Name:E
Last Name:DAPUL-HIDALGO
Suffix:
Gender:F
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:P.O. BOX 34066
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20827
Mailing Address - Country:US
Mailing Address - Phone:240-243-6115
Mailing Address - Fax:
Practice Address - Street 1:15200 SHADY GROVE RD STE 400
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6256
Practice Address - Country:US
Practice Address - Phone:240-243-6115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2024-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101261462207K00000X
MDD73813207K00000X
MDD0073813207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4691024-00Medicaid
VA1952592818Medicaid
MD826726OtherMEDICARE PTAN