Provider Demographics
NPI:1972565406
Name:PACHECO, ELBA M (MD)
Entity type:Individual
Prefix:DR
First Name:ELBA
Middle Name:M
Last Name:PACHECO
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Gender:F
Credentials:MD
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Mailing Address - Street 1:692 A RITCHIE HWY
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-3971
Mailing Address - Country:US
Mailing Address - Phone:410-647-0123
Mailing Address - Fax:410-647-0126
Practice Address - Street 1:692 A RITCHIE HWY
Practice Address - Street 2:SUITE 2B
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-3971
Practice Address - Country:US
Practice Address - Phone:410-647-0123
Practice Address - Fax:410-647-0126
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2020-01-08
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Provider Licenses
StateLicense IDTaxonomies
MDD0038556207W00000X, 207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD530401600Medicaid
MDE14973Medicare UPIN