Healthcare Provider Details

I. General information

NPI: 1558361980
Provider Name (Legal Business Name): GERALD APOLLON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 06/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

826 WASHINGTON RD SUITE 110A
WESTMINSTER MD
21157-5750
US

IV. Provider business mailing address

11901 EVENING CT
CLARKSVILLE MD
21029-1252
US

V. Phone/Fax

Practice location:
  • Phone: 410-751-7480
  • Fax:
Mailing address:
  • Phone: 443-604-4716
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD0037874
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD0037874
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: