Healthcare Provider Details

I. General information

NPI: 1073662029
Provider Name (Legal Business Name): VERONICA DELORES JENKINS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2041 MARTIN LUTHER KING JR AVE SE SUITE M2
WASHINGTON DC
20020-7024
US

IV. Provider business mailing address

10900 KENCREST DR
MITCHELLVILLE MD
20721-2449
US

V. Phone/Fax

Practice location:
  • Phone: 202-889-7900
  • Fax: 202-610-3095
Mailing address:
  • Phone: 301-464-5749
  • Fax: 301-464-8451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberMD18395
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: