Individual
DR. NIRMALADEVI JAYANTHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3328 OLD WASHINGTON RD, WALDORF, MD 20602
(301) 932-4954
(301) 932-5095
Mailing address
PO BOX 1828, WALDORF, MD 20604
(301) 932-4954
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D45737
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
161731100
—
MD
Enumeration date
12/04/2006
Last updated
03/06/2009
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