Healthcare Provider Details

I. General information

NPI: 1306933627
Provider Name (Legal Business Name): JAYESH DAYAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 02/14/2024
Certification Date: 02/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15001 SHADY GROVE ROAD SUITE 120
ROCKVILLE MD
20850-6352
US

IV. Provider business mailing address

15001 SHADY GROVE ROAD SUITE 120
ROCKVILLE MD
20850-6352
US

V. Phone/Fax

Practice location:
  • Phone: 301-251-0070
  • Fax: 301-251-0071
Mailing address:
  • Phone: 301-251-0070
  • Fax: 301-251-0071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberD0044144
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License NumberD0044144
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number0101050237
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberD0044144
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: