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General NPI Number Information
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NPI Number | 1891826392
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Entity Type | Organization
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Legal Business Name | JEREMY J. JANSSEN, M.D., P.C.
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 10/16/2008
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Provider Practice Location Address
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Address Line | 11908 DARNESTOWN RD SUITE C
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City | NORTH POTOMAC
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State | MD
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Zip | 20878-2295
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Country | US
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Telephone | 240-631-1170
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Fax | 240-631-1031
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Provider Business Mailing Address
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Address Line | 11908 DARNESTOWN RD SUITE C
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City | NORTH POTOMAC
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State | MD
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Zip | 20878-2295
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Country | US
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Telephone | 240-631-1170
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Fax | 240-631-1031
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEREMY JAMES JANSSEN
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Credential | M.D.
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Telephone | 240-631-1170
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | D0057305
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License Number State | MD
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