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General NPI Number Information
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NPI Number | 1992790356
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Entity Type | Individual
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Provider Name | JOHN MICHAEL JOLY MD
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Gender | Male
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Dates
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Enumeration Date | 09/13/2005
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Last Update Date | 03/26/2019
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Provider Practice Location Address
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Address Line | 8116 GOOD LUCK RD STE 200
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City | LANHAM
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State | MD
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Zip | 20706-3508
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Country | US
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Telephone | 301-599-9500
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Fax | 301-552-7483
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Provider Business Mailing Address
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Address Line | 7404 EXECUTIVE PL STE 350
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City | LANHAM
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State | MD
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Zip | 20706-6268
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Country | US
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Telephone | 301-599-9500
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Fax | 240-542-2959
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number | MD18198
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | D0028936
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License Number State | MD
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