1528353406 NPI number — DR. ERIC JONAS GAPUD M.D., PH.D.

Table of content: DR. ERIC JONAS GAPUD M.D., PH.D. (NPI 1528353406)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528353406 NPI number — DR. ERIC JONAS GAPUD M.D., PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GAPUD
Provider First Name:
ERIC
Provider Middle Name:
JONAS
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D., PH.D.
Provider Gender Code:
M

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:
1528353406
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5501 BAYVIEW CIRCLE
Provider Second Line Business Mailing Address:
ASTHMA AND ALLERGY BUILDING, SUITE 1B.1
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21224-2734
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-550-6826
Provider Business Mailing Address Fax Number:
410-550-6830

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5200 EASTERN AVE
Provider Second Line Business Practice Location Address:
MFL BUILDING, CENTER TOWER, SUITE 4100
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21224-2734
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-550-6826
Provider Business Practice Location Address Fax Number:
410-550-6830
Provider Enumeration Date:
06/18/2011

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: 207R00000X , with the licence number:  D82962 , 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)

  • Identifier: M90719 . This is a "MARYLAND CDS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: D82962 . This is a "MARYLAND STATE PHYSICIAN LICENSE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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