MEDICARE: DR. MARK GEORGE JANCZEWSKI MD, MPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2083P0500X	Preventive Medicine/Occupational Environmental Medicine Physician	0101041106	VA
2	207Q00000X	Family Medicine Physician	0101041106	VA
3	2083C0008X	Clinical Informatics Physician	0101041106	VA
4	2083A0100X	Aerospace Medicine Physician	0101041106	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0101041106	OTHER	VA	LICENSE
2	ME175967	OTHER	FL	LICENSE

General Provider Information

NPI Number	:	1124022843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK GEORGE JANCZEWSKI MD, MPH

Provider Business Mailing Address
First Line	:	425 S PAYNE ST
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22314-5944
Country	:	US
Telephone Number	:	703-994-7637
Fax Number	:

Provider Business Practice Location Address
First Line	:	425 S PAYNE ST
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22314-5944
Country	:	US
Telephone Number	:	703-994-7637
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	09/03/2025

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