MEDICARE: JUNIPER TMS

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	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1457953598
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JUNIPER TMS

Provider Business Mailing Address
First Line	:	2425 SOLOMONS ISLAND RD UNIT 1B
Second Line	:
City	:	HUNTINGTOWN
State	:	MD
Zip	:	20639-8732
Country	:	US
Telephone Number	:	410-739-8280
Fax Number	:

Provider Business Practice Location Address
First Line	:	2425 SOLOMONS ISLAND RD UNIT 1B
Second Line	:
City	:	HUNTINGTOWN
State	:	MD
Zip	:	20639-8732
Country	:	US
Telephone Number	:	410-739-8280
Fax Number	:

Authorized Official
Title or Position	:	TMS CLINICAL CONSULTANT
Name	:	DIDIER MARCHAL
Credential	:
Telephone Number	:	410-739-8280

Provider Enumeration Date	:	11/13/2020
Last Update Date	:	11/13/2020

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