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Individual

DR. ALLAN JAY CHIRCUS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5310 OLD COURT RD, STE 201, RANDALLSTOWN, MD 21133-5243
(410) 655-1144
(410) 922-7059
Mailing address
5310 OLD COURT RD, STE 201, RANDALLSTOWN, MD 21133-5243
(410) 655-1144
(410) 922-7059

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
D29085
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0400947
AMERICHOICE
01
0456522
AETNA
01
0641413
COVENTRY
05
064141300
MD
01
817268
MDIPA OPT CHOICE MAMSI
01
T411
BLUE CHOICE
Enumeration date
08/26/2005
Last updated
02/15/2013
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