Provider Demographics
NPI:1982049789
Name:MALDONADO, NESTOR JOSE (MD)
Entity Type:Individual
Prefix:
First Name:NESTOR
Middle Name:JOSE
Last Name:MALDONADO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3400 SPRUCE STREET
Mailing Address - Street 2:GROUND SILVERSTEIN BLDG
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4206
Mailing Address - Country:US
Mailing Address - Phone:215-662-6698
Mailing Address - Fax:215-662-3953
Practice Address - Street 1:3400 SPRUCE STREET
Practice Address - Street 2:GROUND SILVERSTEIN BLDG
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4206
Practice Address - Country:US
Practice Address - Phone:215-662-6698
Practice Address - Fax:215-662-3953
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-07
Last Update Date:2023-10-06
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Provider Licenses
StateLicense IDTaxonomies
PAMD472530207P00000X
NJ25MA11188300207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty