Healthcare Provider Details
I. General information
NPI: 1255727764
Provider Name (Legal Business Name): JOHN JUBAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/10/2015
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2001 MEDICAL PKWY
ANNAPOLIS MD
21401-3773
US
IV. Provider business mailing address
700 MELVIN AVE STE 7A
ANNAPOLIS MD
21401-1515
US
V. Phone/Fax
- Phone: 443-481-1000
- Fax:
- Phone: 410-280-2260
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LC0200X |
| Taxonomy | Critical Care Medicine (Anesthesiology) Physician |
| License Number | D87554 |
| License Number State | MD |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | D87554 |
| License Number State | MD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: