Healthcare Provider Details

I. General information

NPI: 1487055034
Provider Name (Legal Business Name): JANET ANN GINGOLD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANET ANN HOBERG MD

II. Dates (important events)

Enumeration Date: 09/12/2014
Last Update Date: 09/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 MICHIGAN AVE NW
WASHINGTON DC
20010-2916
US

IV. Provider business mailing address

13107 WHITEHOLM DR
UPPER MARLBORO MD
20774-1831
US

V. Phone/Fax

Practice location:
  • Phone: 202-476-4858
  • Fax: 888-243-3448
Mailing address:
  • Phone: 301-249-3853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD25108
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: