Detterline, Alvin J

Detterline, Alvin J is an individual health care provider with primary practice located at 8322 Bellona Ave Suite 100, Towson MD 21204-2065. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Detterline, Alvin J can be contacted via phone (410) 337-7900.

Contact Information

Primary practice address
8322 Bellona Ave Suite 100 Towson MD 21204-2065
Phone: (410) 337-7900
Fax: (410) 821-1334
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 35-088976 Ohio
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X D0067412 Maryland

Profile Details

NPI number 1316093180
LBN Legal business name Detterline, Alvin J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 26th, 2007
Last updated Nov 13th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316093180 NPPES
Other D0067412 MARYLAND BOP LICENSE

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