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General NPI Number Information
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NPI Number | 1174826671
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Entity Type | Organization
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Legal Business Name | ALLAN D. JENSEN M.D., P.A.
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Dates
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Enumeration Date | 12/06/2010
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Last Update Date | 12/06/2010
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Provider Practice Location Address
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Address Line | 200 E 33RD ST SUITE 426
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City | BALTIMORE
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State | MD
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Zip | 21218-3322
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Country | US
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Telephone | 410-235-1133
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Fax |
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Provider Business Mailing Address
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Address Line | 200 E 33RD ST SUITE 426
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City | BALTIMORE
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State | MD
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Zip | 21218-3322
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Country | US
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Telephone | 410-235-1133
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALLAN D JENSEN
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Credential | M.D.
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Telephone | 410-235-1133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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