Provider Demographics
NPI:1578583589
Name:HURWITZ, JEFFERY D (MD)
Entity Type:Individual
Prefix:
First Name:JEFFERY
Middle Name:D
Last Name:HURWITZ
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 1:265 MILL ST
Mailing Address - Street 2:STE 600
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-6130
Mailing Address - Country:US
Mailing Address - Phone:240-347-4885
Mailing Address - Fax:240-347-4887
Practice Address - Street 1:265 MILL ST
Practice Address - Street 2:STE 600
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-6130
Practice Address - Country:US
Practice Address - Phone:240-347-4885
Practice Address - Fax:240-347-4887
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0056783207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD110216404OtherRR MEDICARE
MD203401800Medicaid
DC0006 F288OtherBS OF DC
MD608286-01OtherBS OF MD
MD203401800Medicaid
DC0006 F288OtherBS OF DC