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NPI Code Detail

MEDICARE: DR. MARK GEORGE JANCZEWSKI MD, MPH

MEDICARE:  DR. MARK GEORGE JANCZEWSKI  MD, MPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12083P0500XPreventive Medicine/Occupational Environmental Medicine Physician0101041106VA
2207Q00000XFamily Medicine Physician0101041106VA
32083C0008XClinical Informatics Physician0101041106VA
42083A0100XAerospace Medicine Physician0101041106VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10101041106OTHERVALICENSE
2ME175967OTHERFLLICENSE

General Provider Information

NPI Number : 1124022843
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK GEORGE JANCZEWSKI MD, MPH
Provider Business Mailing Address
First Line : 425 S PAYNE ST
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22314-5944
Country : US
Telephone Number : 703-994-7637
Fax Number :
Provider Business Practice Location Address
First Line : 425 S PAYNE ST
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22314-5944
Country : US
Telephone Number : 703-994-7637
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2005
Last Update Date : 09/03/2025

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