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NPI Code Detail

MEDICARE: ALICE HE

MEDICARE: ALICE HE
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
1390200000XStudent in an Organized Health Care Education/Training ProgramH-000-048-454-080MD
2207N00000XDermatology PhysicianD90864MD

General Provider Information

NPI Number : 1972992634
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALICE HE
Provider Business Mailing Address
First Line : 1306 CONCOURSE DR STE 201
Second Line :
City : LINTHICUM
State : MD
Zip : 21090-1033
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2002 MEDICAL PKWY STE 630
Second Line :
City : ANNAPOLIS
State : MD
Zip : 21401-3059
Country : US
Telephone Number : 410-224-2260
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2015
Last Update Date : 07/16/2021

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Directions to “ ALICE HE ” Practice Location

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