Individual
DR. JOSEPH R TIRALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
110 HOSPITAL RD, SUITE #202, PRINCE FREDERICK, MD 20678-4019
(410) 257-3150
(410) 535-3912
Mailing address
110 HOSPITAL RD, SUITE #211, PRINCE FREDERICK, MD 20678-4019
(410) 257-3150
(410) 535-6836
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
D0020619
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2217645
AETNA US HEALTHCARE
—
01
—
366030-03
BLUE SHIELD OF MARYLAND
—
01
—
366483
MAMSI UNITED HEALTH CARE
—
01
—
6906-0002
BLUE SHIELD DC
—
Enumeration date
03/09/2007
Last updated
07/08/2007
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