Healthcare Provider Details

I. General information

NPI: 1053134858
Provider Name (Legal Business Name): MR. ALEX MICHAEL HUFNAGEL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2024
Last Update Date: 11/01/2024
Certification Date: 11/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 SMITH AVE
BALTIMORE MD
21209-2505
US

IV. Provider business mailing address

9906 NEARBROOK LN
PARKVILLE MD
21234-1235
US

V. Phone/Fax

Practice location:
  • Phone: 410-205-9493
  • Fax:
Mailing address:
  • Phone: 443-653-0765
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: