Provider Demographics
NPI:1699758185
Name:TORRES, ERNESTO C (MD)
Entity type:Individual
Prefix:DR
First Name:ERNESTO
Middle Name:C
Last Name:TORRES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:188 THOMAS JOHNSON DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4505
Mailing Address - Country:US
Mailing Address - Phone:301-662-2252
Mailing Address - Fax:301-663-8740
Practice Address - Street 1:188 THOMAS JOHNSON DR
Practice Address - Street 2:SUITE 202
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4505
Practice Address - Country:US
Practice Address - Phone:301-662-2252
Practice Address - Fax:301-663-8740
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-29
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD23651208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDE47771Medicare UPIN