MEDICARE: DR. JIMMIE JULIUS DRUMMOND JR. 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	2083P0500X	Preventive Medicine/Occupational Environmental Medicine Physician	D0037857	MD

General Provider Information

NPI Number	:	1659375004
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JIMMIE JULIUS DRUMMOND JR. MD

Provider Business Mailing Address
First Line	:	12815 ODENS BEQUEST DR
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20720-5615
Country	:	US
Telephone Number	:	410-852-1134
Fax Number	:	410-675-8947

Provider Business Practice Location Address
First Line	:	DILORENZO PENTAGON HEALTH CLINIC 5801 ARMY PENTAGON
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20310-5615
Country	:	US
Telephone Number	:	703-692-8905
Fax Number	:

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

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	11/02/2023

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