MEDICARE: DR. GERALD APOLLON M.D.

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	207P00000X	Emergency Medicine Physician	D0037874	MD
2	207Q00000X	Family Medicine Physician	D0037874	MD

General Provider Information

NPI Number	:	1558361980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GERALD APOLLON M.D.

Provider Business Mailing Address
First Line	:	11901 EVENING CT
Second Line	:
City	:	CLARKSVILLE
State	:	MD
Zip	:	21029-1252
Country	:	US
Telephone Number	:	443-604-4716
Fax Number	:

Provider Business Practice Location Address
First Line	:	826 WASHINGTON RD
Second Line	:	SUITE 110A
City	:	WESTMINSTER
State	:	MD
Zip	:	21157-5750
Country	:	US
Telephone Number	:	410-751-7480
Fax Number	:

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

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	06/12/2013

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