Nissim, Jack E
Nissim, Jack E is an individual health care provider with primary practice located at 7505 Osler Dr 409, Towson MD 21204-7736. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Nissim, Jack E can be contacted via phone (410) 321-5651.Contact Information
Primary practice address
7505 Osler Dr 409
Towson MD 21204-7736
Phone: (410) 321-5651
Fax: (410) 583-0134
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | D0012942 | Maryland |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | D0012942 | Maryland |
Profile Details
| NPI number | 1316029291 |
|---|---|
| LBN Legal business name | Nissim, Jack E |
| Credentials | M./D. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 19th, 2006 |
| Last updated | Aug 28th, 2012 - about 14 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 | 1316029291 | NPPES |
| Other | 4800034 | UNITED HEALTHCARE MCO | |
| MEDICAID | 789201200 | UNITED HEALTHCARE MCO | |
| Other | 0005 E554 | UNITED HEALTHCARE MCO | |
| Other | 34438002 420A | UNITED HEALTHCARE MCO | |
| Other | 274550 | UNITED HEALTHCARE MCO | |
| Other | 290010917 | UNITED HEALTHCARE MCO |
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