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General NPI Number Information
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NPI Number | 1922295237
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Entity Type | Organization
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Legal Business Name | LINDA M. JEFFERSON, MD PA
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Dates
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Enumeration Date | 10/01/2007
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Last Update Date | 06/22/2016
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Provider Practice Location Address
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Address Line | 2670 CRAIN HWY SUITE 410
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City | WALDORF
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State | MD
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Zip | 20601-2806
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Country | US
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Telephone | 301-374-9300
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Fax | 301-374-9469
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Provider Business Mailing Address
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Address Line | 2670 CRAIN HWY SUITE 410
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City | WALDORF
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State | MD
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Zip | 20601-2806
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Country | US
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Telephone | 301-374-9300
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Fax | 301-374-9469
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Authorized Official
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Title or Position | CEO
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Name | LINDA M JEFFERSON
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Credential | MD
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Telephone | 301-374-9300
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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 | D0054004
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License Number State | MD
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