Provider Demographics
NPI:1801135405
Name:KAPLAN, JEROME H (MD)
Entity type:Individual
Prefix:
First Name:JEROME
Middle Name:H
Last Name:KAPLAN
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:POBOX 117
Mailing Address - Street 2:
Mailing Address - City:ST MICHAELS
Mailing Address - State:MD
Mailing Address - Zip Code:21663
Mailing Address - Country:US
Mailing Address - Phone:410-745-6610
Mailing Address - Fax:410-443-0577
Practice Address - Street 1:9330 TILGHMAN ISLAND RD
Practice Address - Street 2:
Practice Address - City:WITTMAN
Practice Address - State:MD
Practice Address - Zip Code:21676
Practice Address - Country:US
Practice Address - Phone:410-745-6610
Practice Address - Fax:410-443-0577
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-04
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00149402085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology