Basic Information
| Provider Information | |||||||||
| NPI: | 1265470199 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOGAN | ||||||||
| FirstName: | GERARD | ||||||||
| MiddleName: | JOSEPH | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 918 EASTERN SHORE DR | ||||||||
| Address2: | |||||||||
| City: | SALISBURY | ||||||||
| State: | MD | ||||||||
| PostalCode: | 218046410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4107491124 | ||||||||
| FaxNumber: | 4107491270 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 E CARROLL ST | ||||||||
| Address2: | |||||||||
| City: | SALISBURY | ||||||||
| State: | MD | ||||||||
| PostalCode: | 218015422 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4107491124 | ||||||||
| FaxNumber: | 4107491270 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/03/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085B0100X | D60182 | MD | X | Allopathic & Osteopathic Physicians | Radiology | Body Imaging | 2085R0202X | D60182 | MD | X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.