Provider Demographics
NPI:1720334683
Name:NTUNE, GERALD
Entity type:Individual
Prefix:
First Name:GERALD
Middle Name:
Last Name:NTUNE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5411 COLUMBIA RD
Mailing Address - Street 2:821
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-5565
Mailing Address - Country:US
Mailing Address - Phone:123-456-7890
Mailing Address - Fax:
Practice Address - Street 1:5411 COLUMBIA RD
Practice Address - Street 2:821
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-5565
Practice Address - Country:US
Practice Address - Phone:123-456-7890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-30
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter