MEDICARE: JEANETTE MCDONALD 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	2084P0800X	Psychiatry Physician	MD 25654	DC

General Provider Information

NPI Number	:	1760602122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANETTE MCDONALD M.D.

Provider Business Mailing Address
First Line	:	2853 ONTARIO RD NW
Second Line	:	301
City	:	WASHINGTON
State	:	DC
Zip	:	20009-2224
Country	:	US
Telephone Number	:	202-797-0052
Fax Number	:

Provider Business Practice Location Address
First Line	:	910 17TH ST NW
Second Line	:	306
City	:	WASHINGTON
State	:	DC
Zip	:	20006-2601
Country	:	US
Telephone Number	:	202-861-1919
Fax Number	:

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

Provider Enumeration Date	:	04/26/2007
Last Update Date	:	07/08/2007

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