Individual
ALIDA I PODRUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12502 WILLOWBROOK RD, SUITE 300, CUMBERLAND, MD 21502-6491
(240) 964-8343
(240) 964-8688
Mailing address
12502 WILLOWBROOK RD, SUITE 300, CUMBERLAND, MD 21502-6491
(240) 964-8343
(240) 964-8688
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
D0063462
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810008582
—
WV
05
—
409570700
—
MD
01
—
567B 646944-02
CAREFIRST BC BS
MD
01
—
K307-0011
GHMSI BLUE CHOICE
DC
Enumeration date
08/10/2005
Last updated
06/08/2010
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