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General NPI Number Information
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NPI Number | 1326080193
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Entity Type | Individual
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Provider Name | MARIA L JISON MD
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Gender | Female
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 07/21/2008
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Provider Practice Location Address
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Address Line | 10400 CONNECTICUT AVE SUITE 206
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City | KENSINGTON
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State | MD
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Zip | 20895-3910
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Country | US
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Telephone | 888-340-3330
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Fax | 240-489-6262
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Provider Business Mailing Address
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Address Line | 11006 VEIRS MILL RD PMB 261
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City | WHEATON
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State | MD
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Zip | 20902-2582
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Country | US
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Telephone | 888-340-3330
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Fax | 240-489-6262
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 010237603
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 0101237603
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | D0054450
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | D0054450
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License Number State | MD
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