Individual
DR. JONATHAN E EFRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4940 EASTERN AVE, BALTIMORE, MD 21224-2735
(410) 550-0100
Mailing address
PO BOX 64563, BALTIMORE, MD 21264-4563
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
D69531
MD
208C00000X
Colon & Rectal Surgery Physician
33553
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
418309600
—
MD
01
—
86080015085259A982
TRIWEST
AZ
05
—
912742
—
AZ
01
—
P00217762
RAILROAD MEDICARE
AZ
Enumeration date
12/12/2005
Last updated
02/10/2014
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