MEDICARE: MR. ALANG M GEH NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP2300X	Primary Care Nurse Practitioner	R220555	MD
2	363L00000X	Nurse Practitioner	R220555	MD

General Provider Information

NPI Number	:	1174389480
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALANG M GEH NP

Provider Business Mailing Address
First Line	:	6101 PARK HEIGHTS AVE APT 1D
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21215-3640
Country	:	US
Telephone Number	:	667-320-0424
Fax Number	:

Provider Business Practice Location Address
First Line	:	6101 PARK HEIGHTS AVE APT 1D
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21215-3640
Country	:	US
Telephone Number	:	667-320-0424
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2024
Last Update Date	:	12/03/2024

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