Basic Information
Provider Information
NPI: 1003824210
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CUEVO
FirstName: RAYMUND
MiddleName: S
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 37174
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212973174
CountryCode: US
TelephoneNumber: 5714235699
FaxNumber: 5714235698
Practice Location
Address1: 8081 INNOVATION PARK DR
Address2:  
City: FAIRFAX
State: VA
PostalCode: 220314867
CountryCode: US
TelephoneNumber: 5714724724
FaxNumber: 5714720241
Other Information
ProviderEnumerationDate: 08/03/2006
LastUpdateDate: 09/10/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/10/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X0101058828VAN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RH0000X0101058828VAN Allopathic & Osteopathic PhysiciansInternal MedicineHematology
207RH0003X0101058828VAN Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
207RX0202X0101058828VAY Allopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology

No ID Information.


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