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NPI Code Detail

MEDICARE: JOSE MA MD

MEDICARE:   JOSE  MA  MD
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
1207Q00000XFamily Medicine PhysicianD0044716MD

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1K729U499OTHERMDMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1518904648
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSE MA MD
Provider Business Mailing Address
First Line : 210 CHESAPEAKE BLVD
Second Line :
City : ELKTON
State : MD
Zip : 21921-6395
Country : US
Telephone Number : 410-620-0545
Fax Number :
Provider Business Practice Location Address
First Line : 4853 PULASKI HWY
Second Line : STE 300
City : PERRYVILLE
State : MD
Zip : 21903-1606
Country : US
Telephone Number : 410-642-2289
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2006
Last Update Date : 02/17/2016

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Directions to “ JOSE MA MD” Practice Location

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