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General NPI Number Information
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NPI Number | 1528231016
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Entity Type | Individual
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Provider Name | JESSICA THERESA PETROS M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/07/2008
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Last Update Date | 02/21/2025
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Provider Practice Location Address
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Address Line | 7474 GREENWAY CENTER DR
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City | GREENBELT
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State | MD
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Zip | 20770-3504
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Country | US
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Telephone | 866-877-7258
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Fax | 240-624-2279
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Provider Business Mailing Address
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Address Line | 8665 GEORGIA AVE
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City | SILVER SPRING
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State | MD
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Zip | 20910-3405
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Country | US
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Telephone | 301-340-7525
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Fax | 301-495-0318
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | D88200
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License Number State | MD
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