Individual
JESSE LOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19851 OBSERVATION DR STE 360, GERMANTOWN, MD 20876-4141
(855) 527-7246
(866) 229-5063
Mailing address
111 S 11TH ST STE 8490, PHILADELPHIA, PA 19107-4824
(215) 503-6476
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
MT227637
PA
208100000X
Physical Medicine & Rehabilitation Physician
4351044760
MI
208100000X
Physical Medicine & Rehabilitation Physician
Primary
D0100095
MD
Other
Enumeration date
06/06/2019
Last updated
04/18/2024
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