MEDICARE: MUKESH JALOTA 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	207P00000X	Emergency Medicine Physician	D0023231	MD

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	60050001	OTHER	MD	DC BLUE CROSS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	60059303	OTHER	MD	BLUE CROSS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	P00382580	OTHER		RAILROAD MCR
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	20047164	OTHER	MD	AMERIHEALTH MERCY HEALTH
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679512099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MUKESH JALOTA MD

Provider Business Mailing Address
First Line	:	17300 AVENLEIGH DR
Second Line	:
City	:	ASHTON
State	:	MD
Zip	:	20861-3633
Country	:	US
Telephone Number	:	301-570-5447
Fax Number	:	301-260-1304

Provider Business Practice Location Address
First Line	:	17300 AVENLEIGH DR
Second Line	:
City	:	ASHTON
State	:	MD
Zip	:	20861-3633
Country	:	US
Telephone Number	:	301-570-5447
Fax Number	:	301-260-1304

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

Provider Enumeration Date	:	06/05/2006
Last Update Date	:	03/18/2011

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Directions to “ MUKESH JALOTA MD” Practice Location

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