Individual
LUIZ MARACAJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
051620
CT
207L00000X
Anesthesiology Physician
Q0751
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051620
CONNECTICUT STATE LICENSE
CT
05
—
340890801
—
TX
01
—
Q0751
TEXAS STATE LICENSE
TX
Enumeration date
08/05/2011
Last updated
06/23/2020
Update your record
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