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Individual

PROF. VICTOR MALDONADO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
4301043142
MI
2085R0202X
Diagnostic Radiology Physician
Primary
4301043142
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0Q26008
BCBS PROVIDER NUMBER
MI
01
0Q26008
BLUE CARE NETWORK
01
1006439
MCCLAREN HEALTH
05
4856349
MI
01
Q26008059
RR MEDICARE
Enumeration date
05/01/2006
Last updated
10/25/2007
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