Individual
RODEGELIO C ESTRADA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
83 SOUTH ST, STE 4, WARE, MA 01082-1660
(413) 967-5588
(413) 967-3166
Mailing address
83 SOUTH ST, STE 4, WARE, MA 01082-1660
(413) 967-5588
(413) 967-3166
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
44191
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0101079
—
MA
01
—
B05040
BLUE CROSS AND BLUE SHIEL
MA
Enumeration date
09/29/2005
Last updated
06/30/2008
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