Healthcare Provider Details

I. General information

NPI: 1255418737
Provider Name (Legal Business Name): BARBARA JANTAUSCH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 09/14/2021
Certification Date: 09/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 MICHIGAN AVE NW
WASHINGTON DC
20010-2978
US

IV. Provider business mailing address

111 MICHIGAN AVE NW
WASHINGTON DC
20010-2978
US

V. Phone/Fax

Practice location:
  • Phone: 202-884-5051
  • Fax:
Mailing address:
  • Phone: 202-884-5051
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License NumberMD16197
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: