Healthcare Provider Details

I. General information

NPI: 1578097093
Provider Name (Legal Business Name): JEREMY GIAMBO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2017
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8930 BROWN DR BLDG 9
BETHESDA MD
20889-5629
US

IV. Provider business mailing address

7131 ARLINGTON RD APT 556
BETHESDA MD
20814-2992
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-6157
  • Fax:
Mailing address:
  • Phone: 401-692-2935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number31010
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number31010
License Number StateNE
# 3
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number31010
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: