Individual
DR. AGATON HOLAZO ESCALANTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3805 NORRISVILLE, BOX 216, JARRETTSVILLE, MD 21084-1421
(410) 557-9322
(410) 557-4451
Mailing address
308 LOCHVIEW TERRACE, LUTHERVILLE, MD 21093-2711
(410) 557-9322
(410) 557-4451
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0017679
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0163901
UNITED HEALTHCARE
—
01
—
041673
US HEALTHCARE
—
01
—
110011897
MEDICARE RAILROAD
MD
01
—
31060005
BCBS
MD
05
—
398861901
—
MD
01
—
660461156
AETNA
—
Enumeration date
11/20/2006
Last updated
01/09/2023
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