1295873370 NPI number — DR. BLANCHE PEARL ALTER MD, MPH

Table of content: DR. BLANCHE PEARL ALTER MD, MPH (NPI 1295873370)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295873370 NPI number — DR. BLANCHE PEARL ALTER MD, MPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALTER
Provider First Name:
BLANCHE
Provider Middle Name:
PEARL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD, MPH
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1295873370
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/20/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9609 MEDICAL CENTER DR
Provider Second Line Business Mailing Address:
ROOM 6E452
Provider Business Mailing Address City Name:
ROCKVILLE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20850-3330
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
240-276-7239
Provider Business Mailing Address Fax Number:
240-276-7836

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9609 MEDICAL CENTER DR
Provider Second Line Business Practice Location Address:
ROOM 6E452
Provider Business Practice Location Address City Name:
ROCKVILLE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20850-3330
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
240-276-7239
Provider Business Practice Location Address Fax Number:
240-276-7836
Provider Enumeration Date:
02/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2080P0207X , with the licence number:  D406 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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