MEDICARE: KARL E DE JONGE MD

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
1	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	MD20969	DC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346293388
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARL E DE JONGE MD

Provider Business Mailing Address
First Line	:	6304 BROAD BRANCH RD
Second Line	:
City	:	CHEVY CHASE
State	:	MD
Zip	:	20815-3342
Country	:	US
Telephone Number	:	202-288-9558
Fax Number	:

Provider Business Practice Location Address
First Line	:	3180 FAIRVIEW PARK DR STE 500
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22042-4516
Country	:	US
Telephone Number	:	703-538-2066
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	11/02/2020

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