Provider Demographics
NPI:1043408263
Name:ALAN M. JONAS AND ROBERT B.LEHMAN M.D.
Entity Type:Organization
Organization Name:ALAN M. JONAS AND ROBERT B.LEHMAN M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:JONAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-602-0555
Mailing Address - Street 1:1314 BEDFORD AVE
Mailing Address - Street 2:SUITE 211
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-6604
Mailing Address - Country:US
Mailing Address - Phone:410-602-0555
Mailing Address - Fax:
Practice Address - Street 1:1314 BEDFORD AVE
Practice Address - Street 2:SUITE 211
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21208-6604
Practice Address - Country:US
Practice Address - Phone:410-602-0555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-12
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD20733174400000X
MDD12899174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDKK67OtherMEDICARE LEGACY
MDD77735Medicare UPIN
MDKK67OtherMEDICARE LEGACY