Provider Demographics
NPI:1538119946
Name:FINK, JEFFREY C (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:C
Last Name:FINK
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:PO BOX 64442
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4442
Mailing Address - Country:US
Mailing Address - Phone:410-705-5280
Mailing Address - Fax:410-328-5685
Practice Address - Street 1:22 S GREENE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1544
Practice Address - Country:US
Practice Address - Phone:410-705-5280
Practice Address - Fax:410-328-5685
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD50777207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0219479000Medicaid
DC034426900Medicaid
VA005841101Medicaid
MD138100800Medicaid
DE0001098801Medicaid
NJ8509701Medicaid
MD543696-01OtherBLUE CROSS/BLUE SHIELD
E65633Medicare UPIN
DE0001098801Medicaid
MD138100800Medicaid
NJ8509701Medicaid