Healthcare Provider Details

I. General information

NPI: 1750548426
Provider Name (Legal Business Name): ALEJANDRO VERA GARCIA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2008
Last Update Date: 01/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 ORLEANS ST BLOOMBERG 7325
BALTIMORE MD
21287-0010
US

IV. Provider business mailing address

2772 LIGHTHOUSE PT E UNIT 212
BALTIMORE MD
21224-5051
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-2960
  • Fax: 410-502-5314
Mailing address:
  • Phone: 845-661-1928
  • Fax: 410-502-5314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License Number251160
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: