Provider Demographics
NPI:1447965157
Name:AGATON H. ESCALANTE, MD, LLC
Entity type:Organization
Organization Name:AGATON H. ESCALANTE, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:AGATON
Authorized Official - Middle Name:H
Authorized Official - Last Name:ESCALANTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-564-6463
Mailing Address - Street 1:308 LOCHVIEW TER
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-2711
Mailing Address - Country:US
Mailing Address - Phone:410-557-9322
Mailing Address - Fax:410-256-2594
Practice Address - Street 1:8870 BELAIR RD
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-2401
Practice Address - Country:US
Practice Address - Phone:410-256-8510
Practice Address - Fax:410-256-2594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-17
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty