MEDICARE: JEREMY MICHAEL DRELICH 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	207K00000X	Allergy & Immunology Physician	D46243	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679560544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEREMY MICHAEL DRELICH M.D.

Provider Business Mailing Address
First Line	:	301 WASHINGTON ST
Second Line	:
City	:	CUMBERLAND
State	:	MD
Zip	:	21502-2828
Country	:	US
Telephone Number	:	301-777-3300
Fax Number	:	301-777-3595

Provider Business Practice Location Address
First Line	:	301 WASHINGTON ST
Second Line	:
City	:	CUMBERLAND
State	:	MD
Zip	:	21502-2828
Country	:	US
Telephone Number	:	301-777-3300
Fax Number	:

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

Provider Enumeration Date	:	10/05/2005
Last Update Date	:	02/08/2023

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