Spivak, Jerry

Spivak, Jerry is an individual health care provider with primary practice located at 600 N Wolfe St , Baltimore MD 21287-0005. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hematology. Allopathic & Osteopathic Physicians / Hematology is his primary health care specialty. Spivak, Jerry can be contacted via phone (410) 955-3142.

Contact Information

Primary practice address
600 N Wolfe St Baltimore MD 21287-0005
Phone: (410) 955-3142
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X D03781 Maryland
Allopathic & Osteopathic Physicians / Hematology 207RH0000X D03781 Maryland

Profile Details

NPI number 1083645303
LBN Legal business name Spivak, Jerry
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 5th, 2006
Last updated Feb 19th, 2013 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083645303 NPPES
Maryland MEDICAID 711651900

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