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General NPI Number Information
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NPI Number | 1922425669
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Entity Type | Organization
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Legal Business Name | JEANNINE GEORGE-RICHARDSON, DPM
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Dates
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Enumeration Date | 03/19/2014
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Last Update Date | 08/02/2016
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Provider Practice Location Address
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Address Line | 2 E ROLLING CROSSROADS SUITE 152
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City | CATONSVILLE
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State | MD
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Zip | 21228-6211
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Country | US
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Telephone | 410-869-4147
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Fax | 410-869-4149
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Provider Business Mailing Address
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Address Line | 2201 SAVANNAH ST SE
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City | WASHINGTON
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State | DC
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Zip | 20020-7536
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Country | US
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Telephone | 410-489-4747
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Fax | 410-869-4149
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Authorized Official
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Title or Position | PODIATRIST
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Name | JEANNINE E. GEORGE-RICHARDSON
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Credential | DPM
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Telephone | 410-869-4147
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 01417
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | PO1000047
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License Number State | DC
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