Individual
JERROLD S. CANAKIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10344 OLD OCN BLVD, BERLIN, MD 21811
(410) 641-2938
(410) 641-4904
Mailing address
100 E CARROLL ST, SALISBURY, MD 21801-5422
(410) 546-6400
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
C10006596
DE
207RG0100X
Gastroenterology Physician
Primary
D0059594
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
400997500
—
MD
Enumeration date
10/11/2005
Last updated
08/22/2018
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