Basic Information
| Provider Information | |||||||||
| NPI: | 1871561043 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | INSEL | ||||||||
| FirstName: | JERALD | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8114 SANDPIPER CIR STE 206 | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212365902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4109334923 | ||||||||
| FaxNumber: | 4109338659 | ||||||||
| Practice Location | |||||||||
| Address1: | 5601 LOCH RAVEN BLVD | ||||||||
| Address2: | RUSSELL MORGAN BLDG., SUITE 206 | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212392905 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4104645600 | ||||||||
| FaxNumber: | 4105324606 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/14/2006 | ||||||||
| LastUpdateDate: | 07/31/2015 | ||||||||
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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 | 207RC0000X | D37280 | MD | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 283701300 | 05 | MD | MEDICAID |