Basic Information
| Provider Information | |||||||||
| NPI: | 1063617975 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ADLER | ||||||||
| FirstName: | MATTHEW | ||||||||
| MiddleName: | ISRAEL | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7556 TEAGUE RD | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | HANOVER | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210761213 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105510499 | ||||||||
| FaxNumber: | 4107999070 | ||||||||
| Practice Location | |||||||||
| Address1: | 7556 TEAGUE RD | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | HANOVER | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210761213 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105510499 | ||||||||
| FaxNumber: | 4107999070 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/19/2007 | ||||||||
| LastUpdateDate: | 09/30/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | D71101 | MD | Y | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | MD439290 | PA | N | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.