Provider Demographics
NPI:1568496180
Name:PARGAMENT, JEFFREY MARK (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:MARK
Last Name:PARGAMENT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9518 PHILADELPHIA RD
Mailing Address - Street 2:STE B
Mailing Address - City:BALTO
Mailing Address - State:MD
Mailing Address - Zip Code:21237-4106
Mailing Address - Country:US
Mailing Address - Phone:410-682-2202
Mailing Address - Fax:410-682-2203
Practice Address - Street 1:9518 PHILADELPHIA RD
Practice Address - Street 2:STE B
Practice Address - City:BALTO
Practice Address - State:MD
Practice Address - Zip Code:21237-4106
Practice Address - Country:US
Practice Address - Phone:410-682-2202
Practice Address - Fax:410-682-2203
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2010-06-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD18642207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD779901200Medicaid
MD779901200Medicaid
D73803Medicare UPIN