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General NPI Number Information
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NPI Number | 1952001521
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Entity Type | Organization
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Legal Business Name | JONATHAN R VAN METER MD
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Dates
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Enumeration Date | 03/03/2023
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Last Update Date | 03/03/2023
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Provider Practice Location Address
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Address Line | 164 W MAIN ST STE B
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City | NEW MARKET
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State | MD
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Zip | 21774-6279
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Country | US
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Telephone | 301-882-8470
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Fax |
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Provider Business Mailing Address
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Address Line | 164 W MAIN ST STE B
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City | NEW MARKET
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State | MD
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Zip | 21774-6279
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Country | US
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Telephone | 301-882-8470
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JONATHAN VAN METER
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Credential | M.D.
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Telephone | 301-882-8470
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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