Provider Demographics
NPI:1538165964
Name:ESPIRIDION, EDUARDO DEL ROSARIO (MD)
Entity type:Individual
Prefix:DR
First Name:EDUARDO
Middle Name:DEL ROSARIO
Last Name:ESPIRIDION
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:11015 SANI LN
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-4034
Mailing Address - Country:US
Mailing Address - Phone:301-797-4069
Mailing Address - Fax:
Practice Address - Street 1:13114 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-2741
Practice Address - Country:US
Practice Address - Phone:240-520-8287
Practice Address - Fax:240-566-3018
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD066842L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0124730Medicaid
260000489Medicare ID - Type Unspecified
H20755Medicare UPIN