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Individual
RODEGELIO C ESTRADA
Active
Individual
RODEGELIO C ESTRADA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
44191
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0101079
—
MA
01
—
B05040
BLUE CROSS AND BLUE SHIEL
MA
Enumeration date
09/29/2005
Last updated
06/30/2008
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