Healthcare Provider Details

I. General information

NPI: 1013020718
Provider Name (Legal Business Name): JANE M. LINGELBACH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11886 HEALING WAY STE 580
SILVER SPRING MD
20904-7917
US

IV. Provider business mailing address

5811 EDSON LN APT 101
ROCKVILLE MD
20852-2914
US

V. Phone/Fax

Practice location:
  • Phone: 240-396-4871
  • Fax: 301-270-7249
Mailing address:
  • Phone: 240-396-4871
  • Fax: 301-270-7249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberD0056923
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: