Healthcare Provider Details

I. General information

NPI: 1174389480
Provider Name (Legal Business Name): ALANG M GEH NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2024
Last Update Date: 12/03/2024
Certification Date: 12/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6101 PARK HEIGHTS AVE APT 1D
BALTIMORE MD
21215-3640
US

IV. Provider business mailing address

6101 PARK HEIGHTS AVE APT 1D
BALTIMORE MD
21215-3640
US

V. Phone/Fax

Practice location:
  • Phone: 667-320-0424
  • Fax:
Mailing address:
  • Phone: 667-320-0424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR220555
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberR220555
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: