# CUSTODIO A. GARRIDO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1205811676
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 01041472A | IN | Yes |

## Other

- **Enumeration date:** 12/08/2005
- **Last updated:** 03/24/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000175779 | ANTHEM | IN |
| 01 | — | 000000183201 | ANTHEM | IN |
| 01 | — | 000000570547 | ANTHEM | IN |
| 01 | — | 00001336580 02 | UNITED HEALTHCARE | — |
| 01 | — | 080130069 | RAILROAD MEDICARE | IN |
| 05 | — | 100381020 | — | IN |
| 01 | — | 2822 | PHYSICIANS HEALTH PLAN | IN |
| 01 | — | 3937240017 | MEDICARE DMEPOS | IN |
| 01 | — | 4556205 | AETNA | — |