MEDICARE: ALVANUS HOWLAND HARTLEY MD

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	207N00000X	Dermatology Physician	D0038429	MD
2	207NP0225X	Pediatric Dermatology Physician	D0038429	MD

General Provider Information

NPI Number	:	1336213503
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALVANUS HOWLAND HARTLEY MD

Provider Business Mailing Address
First Line	:	995 PRINCE FREDERICK BLVD
Second Line	:	SUITE 204
City	:	PRINCE FREDERICK
State	:	MD
Zip	:	20678-3198
Country	:	US
Telephone Number	:	410-535-5855
Fax Number	:	410-535-6574

Provider Business Practice Location Address
First Line	:	995 PRINCE FREDERICK BLVD
Second Line	:	SUITE 204
City	:	PRINCE FREDERICK
State	:	MD
Zip	:	20678-3198
Country	:	US
Telephone Number	:	410-535-5855
Fax Number	:	410-535-6574

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

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	04/02/2014

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Directions to “ ALVANUS HOWLAND HARTLEY MD” Practice Location

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