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Individual

RODRIGO C HURTADO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3450 N BEAUREGARD ST, STE 1, ALEXANDRIA, VA 22302-1200
(703) 820-7000
(703) 931-0059
Mailing address
3450 N BEAUREGARD ST, STE 1, ALEXANDRIA, VA 22302-1200
(703) 820-7000
(703) 931-0059

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
0101023928
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0004
B/C B/S INDIVIDUAL #
VA
01
036036
ANTHEM
VA
01
2156
B/C B/S GROUP #
VA
01
246822
MAMSI
VA
01
4086177
AETNA
VA
Enumeration date
05/23/2005
Last updated
07/08/2007
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