Gradon, Jeremy D
Gradon, Jeremy D is an individual health care provider with primary practice located at 2435 W Belvedere Ave Suite 17, Baltimore MD 21215-5224. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Infectious Disease, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Infectious Disease is his primary health care specialty. Gradon, Jeremy D can be contacted via phone (410) 601-5941.Contact Information
Primary practice address
2435 W Belvedere Ave Suite 17
Baltimore MD 21215-5224
Phone: (410) 601-5941
Fax: (410) 601-6006
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | D42061 | Maryland |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | D42061 | Maryland |
Profile Details
| NPI number | 1124078340 |
|---|---|
| LBN Legal business name | Gradon, Jeremy D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 10th, 2006 |
| Last updated | Dec 30th, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124078340 | NPPES |
| Maryland | Other | 440000509 | R/R MEDICARE PROVIDER # |
| Maryland | Other | CC3778 | R/R MEDICARE PROVIDER # |
| Maryland | MEDICAID | 182401500 | R/R MEDICARE PROVIDER # |
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