Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 21437 | MD |
N | 2251S0007X | Physical Therapist - Sports | 21437 | MD |
NPI | 1487786810 |
---|---|
Provider Name | Dr. Jeremy S Alter |
First Address | Baltimore, MD 21209-3746 |
Second Address | Baltimore, MD 21209-3746 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2007 |
Last Update Date | 06/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2160584 | ACN (01) | |
2160584 | UNITED HEALTHCARE (01) | |
7914198 | AETNA (01) | |
T208 | BLUECHOICE/GHMSI (01) |