Provider Demographics
NPI:1982794012
Name:HALLEGADO, ARLENE (MD)
Entity Type:Individual
Prefix:
First Name:ARLENE
Middle Name:
Last Name:HALLEGADO
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 1:1000 BRABHAM LN
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-5003
Mailing Address - Country:US
Mailing Address - Phone:910-341-3300
Mailing Address - Fax:910-251-2067
Practice Address - Street 1:1000 BRABHAM LN
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-5003
Practice Address - Country:US
Practice Address - Phone:910-341-3300
Practice Address - Fax:910-251-2067
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2016-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2012-01744207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ411537OtherCIGNA
NJ5902147OtherGHI
NJ13714OtherUHP
NJ478425OtherAETNA
NJ6689701Medicaid
NJOK9025OtherHEALTHNET
NJ0314423001OtherAMERIHEALTH
NJ1864386OtherUNITED
NJEP265OtherOXFORD
NJ223620928OtherLOCAL 472
NJ1067718OtherNJ HEALTH
NJ01000059400OtherAMERICHOICE
NJ81448OtherAMERIGROUP
NJJ2399OtherHORIZON
NJ478425OtherAETNA
F92240Medicare UPIN
NJF92240Medicare UPIN