Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | D0006791 | MD |
NPI | 1003993924 |
---|---|
Provider Name | Dr. Alfred Kronthal |
First Address | Towson, MD 21204-6810 |
Second Address | Baltimore, MD 21211-2109 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 23/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
026421100 | (05) | MD |
C57425 | (02) | MD |
E6890000 | BCBS DC PROVIDER # (01) | DC |
LS06 | BCBS MD PROVIDER # (01) | MD |