Provider Demographics
NPI:1154524916
Name:ROJAS, DAVID ALBERTO (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:ALBERTO
Last Name:ROJAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10354 LOMBARDI DR
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-2150
Mailing Address - Country:US
Mailing Address - Phone:410-461-1345
Mailing Address - Fax:
Practice Address - Street 1:10102 COUNTRY CLUB RD SE
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-8339
Practice Address - Country:US
Practice Address - Phone:301-777-2405
Practice Address - Fax:301-777-2364
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0020242283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDB70954Medicare UPIN