Healthcare Provider Details

I. General information

NPI: 1871561043
Provider Name (Legal Business Name): JERALD INSEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8114 SANDPIPER CIR STE 206
NOTTINGHAM MD
21236-5902
US

IV. Provider business mailing address

8114 SANDPIPER CIR STE 206
BALTIMORE MD
21236-5902
US

V. Phone/Fax

Practice location:
  • Phone: 410-933-4923
  • Fax: 410-933-8659
Mailing address:
  • Phone: 410-933-4923
  • Fax: 410-933-8659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberD37280
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: