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NPI Code Detail

MEDICARE: DR. JONATHAN IRA SEGAL MD

MEDICARE: DR. JONATHAN IRA SEGAL 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
1207R00000XInternal Medicine Physician0101273918VA
2207UN0901XNuclear Cardiology Physician0101273918VA
3207RC0000XCardiovascular Disease Physician0101273918VA

General Provider Information

NPI Number : 1902293210
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JONATHAN IRA SEGAL MD
Provider Business Mailing Address
First Line : PO BOX 37174
Second Line :
City : BALTIMORE
State : MD
Zip : 21297-3174
Country : US
Telephone Number : 571-423-5699
Fax Number : 571-423-5698
Provider Business Practice Location Address
First Line : 4825 MARK CENTER DR STE 150
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22311-1846
Country : US
Telephone Number : 703-751-8111
Fax Number : 703-751-1105
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2015
Last Update Date : 04/01/2025

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Directions to “ DR. JONATHAN IRA SEGAL MD” Practice Location

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