Provider Demographics
NPI:1174547848
Name:PEREZ-ALARD, JORGE (MD)
Entity type:Individual
Prefix:DR
First Name:JORGE
Middle Name:
Last Name:PEREZ-ALARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3708 MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-2025
Mailing Address - Country:US
Mailing Address - Phone:410-255-1600
Mailing Address - Fax:410-255-7380
Practice Address - Street 1:3708 MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-2025
Practice Address - Country:US
Practice Address - Phone:410-255-1600
Practice Address - Fax:410-255-7380
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0041927207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDK790BL55Medicare PIN
MDF23350Medicare UPIN