Provider Demographics
NPI:1336109222
Name:JERREMS, DANIEL L (PA)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:L
Last Name:JERREMS
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7505 OSLER DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-7736
Mailing Address - Country:US
Mailing Address - Phone:410-337-8888
Mailing Address - Fax:410-823-4833
Practice Address - Street 1:7505 OSLER DR
Practice Address - Street 2:SUITE 104
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7736
Practice Address - Country:US
Practice Address - Phone:410-337-8888
Practice Address - Fax:410-823-4833
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2013-11-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDC0000325363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant