Provider Demographics
NPI:1386776193
Name:ALONZO, RUBY C (MD)
Entity type:Individual
Prefix:DR
First Name:RUBY
Middle Name:C
Last Name:ALONZO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:110 HOSPITAL RD
Mailing Address - Street 2:SUITE #211
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678-4019
Mailing Address - Country:US
Mailing Address - Phone:410-535-5610
Mailing Address - Fax:410-535-6836
Practice Address - Street 1:110 HOSPITAL RD
Practice Address - Street 2:SUITE #211
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-4019
Practice Address - Country:US
Practice Address - Phone:410-535-5610
Practice Address - Fax:410-535-6836
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0029702207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
6906-0001OtherBLUE SHIELD DC
367313OtherMAMSI UNITED HEALTH CARE
410213-03OtherBLUE SHIELD OF MARYLAND
2217644OtherAETNA US HEALTHCARE
367313OtherMAMSI UNITED HEALTH CARE
410213-03OtherBLUE SHIELD OF MARYLAND