=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346319787
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GERALD H. FINK, M.D., P.A.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/07/2006
-----------------------------------------------------
Last Update Date | 04/14/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11200 DEBORAH DR
-----------------------------------------------------
City | POTOMAC
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20854-2723
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-765-1011
-----------------------------------------------------
Fax | 301-765-1011
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11200 DEBORAH DR
-----------------------------------------------------
City | POTOMAC
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20854-2723
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-765-1011
-----------------------------------------------------
Fax | 301-765-1011
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. GERALD HOWARD FINK
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 301-765-1011
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | D0002125
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------