MEDICARE: DR. JONATHAN HUNTER JAFFIN M.D.

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	208600000X	Surgery Physician	25MA04904100	NJ

General Provider Information

NPI Number	:	1124181847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JONATHAN HUNTER JAFFIN M.D.

Provider Business Mailing Address
First Line	:	9032 ROUEN LN
Second Line	:
City	:	POTOMAC
State	:	MD
Zip	:	20854-3130
Country	:	US
Telephone Number	:	301-619-7378
Fax Number	:

Provider Business Practice Location Address
First Line	:	504 SCOTT ST
Second Line	:
City	:	FORT DETRICK
State	:	MD
Zip	:	21702-5012
Country	:	US
Telephone Number	:	301-619-7378
Fax Number	:

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

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	07/08/2007

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