Individual
JEROME J UPCHURCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SA-C, CSFA
Contact information
Practice address
15811 CHAGALL TER, NORTH POTOMAC, MD 20878-3461
(215) 518-2138
Mailing address
15811 CHAGALL TER, NORTH POTOMAC, MD 20878-3461
(215) 518-2138
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
02/16/2017
Last updated
09/12/2018
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