Provider Demographics
NPI:1194765958
Name:MACHIRAN, NORBERTO MIGUEL (MD)
Entity type:Individual
Prefix:DR
First Name:NORBERTO
Middle Name:MIGUEL
Last Name:MACHIRAN
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 1:720-C MAIDEN CHOICE LANE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21228
Mailing Address - Country:US
Mailing Address - Phone:410-744-5900
Mailing Address - Fax:410-455-0894
Practice Address - Street 1:720-C MAIDEN CHOICE LANE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21228
Practice Address - Country:US
Practice Address - Phone:410-744-5900
Practice Address - Fax:410-455-0894
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD16200207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD053471400Medicaid
B69613Medicare UPIN
MD5557Medicare ID - Type Unspecified