Healthcare Provider Details

I. General information

NPI: 1053382796
Provider Name (Legal Business Name): JANE E PINESS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2006
Last Update Date: 08/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26005 RIDGE ROAD SUITE 200
DAMASCUS MD
20872-1899
US

IV. Provider business mailing address

26005 RIDGE ROAD SUITE 200
DAMASCUS MD
20872-1899
US

V. Phone/Fax

Practice location:
  • Phone: 301-414-2300
  • Fax: 301-414-2306
Mailing address:
  • Phone: 301-414-2300
  • Fax: 301-414-2306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number0101045298
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberD0078671
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: