Miguel a Heredia, MD PA

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

D0004971 Issued in MD

Legal business name

MIGUEL A HEREDIA, MD PA

Practice address

413 Commonwealth Ave
Baltimore, MD 21228-3044

Phone

(410) 788-6575

Fax

(410) 744-1088

NPI assigned

Apr 28, 2010

Last updated

Apr 28, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Miguel Arquimedes Heredia, M.D.

Title

Medical Doctor

Phone

(410) 788-6575

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1272412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272412800000",
    "number": "1659698827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 COMMONWEALTH AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212283044",
            "telephone_number": "410-788-6575",
            "fax_number": "410-744-1088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 COMMONWEALTH AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212283044",
            "telephone_number": "410-788-6575",
            "fax_number": "410-744-1088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIGUEL A HEREDIA, MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-28",
        "last_updated": "2010-04-28",
        "status": "A",
        "authorized_official_last_name": "HEREDIA",
        "authorized_official_first_name": "MIGUEL",
        "authorized_official_middle_name": "ARQUIMEDES",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "410-788-6575",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "MD",
            "license": "D0004971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "068121100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mighty Behavioral Health Services
• Mighty Behavioral Health Services
• Mighty Behavioral Health Services
• Mighty Behavioral Health Services
• Joseph Anthony Migliazzo
• Olivia Kathryn Mihulka Hartman, MD
• Yianni Mikalis, LCPC, LCPAT
• Jamal A Mikdashi, M.D.
• Marita Kathrn Mike, MD
• Maia Mikeladze

• Health Maintenance Organization in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Health Maintenance Organization in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.