MEDICARE: JEANETTE DU

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	390200000X	Student in an Organized Health Care Education/Training Program
2	207W00000X	Ophthalmology Physician	MD210011553	DC

General Provider Information

NPI Number	:	1760941538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANETTE DU

Provider Business Mailing Address
First Line	:	8270 WILLOW OAKS CORPORATE DR
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22031-4530
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5454 WISCONSIN AVE STE 1700
Second Line	:
City	:	CHEVY CHASE
State	:	MD
Zip	:	20815-6951
Country	:	US
Telephone Number	:	301-656-8100
Fax Number	:	301-465-3202

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

Provider Enumeration Date	:	03/19/2019
Last Update Date	:	05/26/2026

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Directions to “ JEANETTE DU ” Practice Location

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