MEDICARE: DR. JURIS PAUL GERMANAS M.D.

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	207N00000X	Dermatology Physician	D0064303	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	M0086	OTHER	TX	PHYSICIAN'S LICENSE
2	D0064303	OTHER	MD	LICENSE

General Provider Information

NPI Number	:	1447210794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JURIS PAUL GERMANAS M.D.

Provider Business Mailing Address
First Line	:	1502 S MAIN ST
Second Line	:	SUITE 304
City	:	MOUNT AIRY
State	:	MD
Zip	:	21771-5325
Country	:	US
Telephone Number	:	301-829-4185
Fax Number	:	301-829-4187

Provider Business Practice Location Address
First Line	:	1502 S MAIN ST
Second Line	:	SUITE 304
City	:	MOUNT AIRY
State	:	MD
Zip	:	21771-5325
Country	:	US
Telephone Number	:	301-829-4185
Fax Number	:	301-829-4187

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

Provider Enumeration Date	:	03/23/2006
Last Update Date	:	02/28/2017

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