Organization
PENINSULA PULMONARY ASSOC PA
Active
Organization
PENINSULA PULMONARY ASSOC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM J NAGEL MD (PRESIDENT)
(410) 543-7722
Entity
Organization
Contact information
Practice address
100 EAST CARROLL ST, PRMC STATION #379, SALISBURY, MD 21801-5422
(410) 543-7722
(410) 543-7725
Mailing address
100 EAST CARROLL ST, PRMC STATION #379, SALISBURY, MD 21801-5422
(410) 543-7722
(410) 543-7725
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000631802
MEDICAL ASSISTANCE
DE
01
—
1503877
UNITED MINE WORKERS
—
01
—
229675
MAMSI
—
01
—
CA8835
RAILROAD MEDICARE
—
01
—
E601
BLUE SHIELD NATL CAPITAL
—
01
—
KU52PE
BLUE CROSS BLUE SHIELD
MD
Enumeration date
11/01/2005
Last updated
08/22/2020
Update your record
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