Provider Demographics
NPI:1538273966
Name:SEGAL, ALAN R (MD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:R
Last Name:SEGAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1517 HUGO CIR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-5917
Mailing Address - Country:US
Mailing Address - Phone:301-949-1220
Mailing Address - Fax:301-949-5757
Practice Address - Street 1:1517 HUGO CIR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-5917
Practice Address - Country:US
Practice Address - Phone:301-949-1220
Practice Address - Fax:301-949-5757
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD52261207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD81130001OtherBCBS DC
MD901300800Medicaid
MD54676704OtherBCBS MD INDIVIDUAL
MD0101037OtherEVERCARE
MD490644Medicare ID - Type Unspecified
MD81130001OtherBCBS DC