Individual
DR. JEFFREY T HIRATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2002 MEDICAL PKWY, SUITE 235, ANNAPOLIS, MD 21401-3046
(410) 266-2770
(410) 841-6251
Mailing address
2002 MEDICAL PKWY, SUITE 235, ANNAPOLIS, MD 21401-3046
(410) 266-2770
(410) 841-6251
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
A102941
CA
2085R0202X
Diagnostic Radiology Physician
Primary
D0064802
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1069
BCBS ARA
MD
01
—
1073
BCBS AAD
MD
01
—
154158ZDYC
ARA MEDICARE GROUP PTAN
ME
01
—
1863725
AAD AMERIGROUP
MD
01
—
417295700
AAD MEDICAL ASSISTANCE
MD
01
—
764801400
MEDICAID AAD
MD
01
—
G0178
MEDICARE AAD
MD
01
—
K606AN
AAD BOWIE
ME
01
—
S645
MEDICARE AAD
MD
Enumeration date
03/12/2007
Last updated
11/22/2013
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