Provider Demographics
NPI:1306935176
Name:RODRIGUEZ, IGNACIO R (MD)
Entity type:Individual
Prefix:DR
First Name:IGNACIO
Middle Name:R
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8757 GEORGIA AVENUE
Mailing Address - Street 2:STE 430
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910
Mailing Address - Country:US
Mailing Address - Phone:301-608-0833
Mailing Address - Fax:301-608-0835
Practice Address - Street 1:8757 GEORGIA AVENUE
Practice Address - Street 2:430
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910
Practice Address - Country:US
Practice Address - Phone:301-608-0833
Practice Address - Fax:301-608-0835
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD00202412084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
R0437831Medicare ID - Type Unspecified
C89037Medicare UPIN