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General NPI Number Information
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NPI Number | 1891937769
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Entity Type | Organization
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Legal Business Name | GERMANTOWN PRIMARY CARE ASSOCIATES P C
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Dates
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Enumeration Date | 03/24/2009
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Last Update Date | 05/21/2009
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Provider Practice Location Address
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Address Line | 19500 AMARANTH DR SUITE B
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City | GERMANTOWN
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State | MD
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Zip | 20874-1209
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Country | US
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Telephone | 301-528-7110
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Fax |
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Provider Business Mailing Address
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Address Line | 19500 AMARANTH DR SUITE B
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City | GERMANTOWN
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State | MD
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Zip | 20874-1209
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Country | US
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Telephone | 301-528-7110
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DANIEL A JALLER
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Credential |
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Telephone | 301-528-7110
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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 | D0033138
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License Number State | MD
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