MEDICARE: DR. FRED GELIN PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	551	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	319788	OTHER	MD	MDIPA
2	4379918	OTHER	MD	AETNA PPO
3	R003-0001	OTHER		BC/BS FEDERAL
4	319788	OTHER	MD	OPTIMUM CHOICE
5	319788	OTHER	MD	MAMSI
6	3584341	OTHER	MD	AETNA HMO
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	T159FR	OTHER	MD	BC/BS
9	R003-0001	OTHER		BC/BS BLUECHOICE

General Provider Information

NPI Number	:	1386641652
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. FRED GELIN PA

Provider Business Mailing Address
First Line	:	7809 WISE AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21222-3339
Country	:	US
Telephone Number	:	410-288-0666
Fax Number	:	410-288-0667

Provider Business Practice Location Address
First Line	:	7809 WISE AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21222-3339
Country	:	US
Telephone Number	:	410-288-0666
Fax Number	:	410-288-0667

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. FRED GELIN
Credential	:	D.P.M.
Telephone Number	:	410-288-0666

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	12/19/2008

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Directions to “DR. FRED GELIN PA ” Practice Location

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