Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | D64 6 03 | MD |
N | 207RP1001X | Pulmonary Disease | D64603 | MD |
Y | 207RS0012X | Sleep Medicine | D64603 | MD |
NPI | 1063448322 |
---|---|
Provider Name | Dr. Avelino Catalino Verceles |
First Address | Baltimore, MD 21264-4442 |
Second Address | Baltimore, MD 21201-1544 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2006 |
Last Update Date | 15/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1063448322 | (05) | DE |
410732200 | (05) | MD |
888757-01 | BLUE CROSS/BLUE SHIELD (01) | MD |
I24519 | (02) |