Healthcare Provider Details

I. General information

NPI: 1295041580
Provider Name (Legal Business Name): JUDITH HEDJE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2010
Last Update Date: 08/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 DENNIS AVE
SILVER SPRING MD
20902-4136
US

IV. Provider business mailing address

5750 BOU AVE UNIT 1017
ROCKVILLE MD
20852-1645
US

V. Phone/Fax

Practice location:
  • Phone: 240-777-1743
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberD0060530
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: