Provider Demographics
NPI:1487786810
Name:ALTER, JEREMY S (PT, DSCPT)
Entity type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:S
Last Name:ALTER
Suffix:
Gender:M
Credentials:PT, DSCPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 QUARRY LAKE DR STE 300
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-3746
Mailing Address - Country:US
Mailing Address - Phone:410-377-8900
Mailing Address - Fax:410-377-0576
Practice Address - Street 1:2700 QUARRY LAKE DR STE 300
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-3746
Practice Address - Country:US
Practice Address - Phone:410-377-8900
Practice Address - Fax:410-377-0576
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2020-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD214372251S0007X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Provider Identifiers
StateIdentifier IDID TypeIssuer
7914198OtherAETNA
T208OtherBLUECHOICE/GHMSI
2160584OtherACN
2160584OtherUNITED HEALTHCARE