Provider Demographics
NPI:1922370121
Name:JEFFREY D. HURWITZ, MD LLC
Entity Type:Organization
Organization Name:JEFFREY D. HURWITZ, MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:HURWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:240-347-4885
Mailing Address - Street 1:265 MILL ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-6130
Mailing Address - Country:US
Mailing Address - Phone:301-964-9927
Mailing Address - Fax:
Practice Address - Street 1:265 MILL ST
Practice Address - Street 2:SUITE 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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-02
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0056783261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care