DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: JORDAN BARRETT NALLS

MEDICARE: JORDAN BARRETT NALLS
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
1363AS0400XSurgical Physician Assistant

General Provider Information

NPI Number : 1417892878
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORDAN BARRETT NALLS
Provider Business Mailing Address
First Line : 14530 DORSEY MILL RD
Second Line :
City : GLENWOOD
State : MD
Zip : 21738-9320
Country : US
Telephone Number : 240-394-2580
Fax Number :
Provider Business Practice Location Address
First Line : 910 FREDERICK RD
Second Line :
City : CATONSVILLE
State : MD
Zip : 21228-4516
Country : US
Telephone Number : 410-644-1880
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2026
Last Update Date : 06/04/2026

Similar Medicare Providers

1851394977 — MR. GERARD JOSEPH SCIBILIA MPT
Practice Location Address:
910 FREDERICK RD
CATONSVILLE, MD
21228-4516
Practice Phone: 410-644-1880
Practice Fax: 410-646-3623
1205838406 — DR. OREN GIL BLAM M.D.
Practice Location Address:
910 FREDERICK RD
CATONSVILLE, MD
21228-4516
Practice Phone: 410-644-1880
Practice Fax: 410-646-3623
1821092693 — DR. RICHARD DENNIS KINNARD SR. M.D.
Practice Location Address:
910 FREDERICK RD
CATONSVILLE, MD
21228-4516
Practice Phone: 410-644-1880
Practice Fax: 410-646-3623
1144224916 — DR. MORRIS BRIAN POLSKY M.D.
Practice Location Address:
910 FREDERICK RD
CATONSVILLE, MD
21228-4516
Practice Phone: 410-644-1880
Practice Fax: 410-646-3623
1518961283 — DR. SAM VIJAYKUMAR SYDNEY M.D.
Practice Location Address:
910 FREDERICK RD
CATONSVILLE, MD
21228-4516
Practice Phone: 410-644-1880
Practice Fax: 410-646-3623
1376547125 — DR. NICHOLAS PATRICK GROSSO MD
Practice Location Address:
910 FREDERICK RD
CATONSVILLE, MD
21228-4516
Practice Phone: 410-644-1880
Practice Fax: 410-646-3623

Directions to “ JORDAN BARRETT NALLS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.