Provider Demographics
NPI:1114981065
Name:GERINGER, ALAN MARK (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:MARK
Last Name:GERINGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:722 DULANEY VALLEY RD STE 141
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-5109
Mailing Address - Country:US
Mailing Address - Phone:443-970-3608
Mailing Address - Fax:949-561-4415
Practice Address - Street 1:2500 W ROGERS AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-4131
Practice Address - Country:US
Practice Address - Phone:443-970-3608
Practice Address - Fax:949-561-4415
Is Sole Proprietor?:No
Enumeration Date:2006-04-15
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD29143208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD372001200Medicaid
MDB70617Medicare UPIN
MD157912ZR0ZMedicare PIN
MD157676Medicare PIN
MD063RMedicare PIN
MD157912ZD2XMedicare PIN