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DR. DANIEL ANDREW JALLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
19500 AMARANTH DR, SUITE A, GERMANTOWN, MD 20874-1209
(301) 528-7111
Mailing address
19500 AMARANTH DR, SUITE A, GERMANTOWN, MD 20874-1209
(301) 528-7111

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0033138
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1327648
CIGNA PROVIDER NUMBER
MD
01
42444606
BSMD
MD
01
499694
NCCPO
MD
01
521186611
UNITED HEALTHCARE PROV #
MD
01
8140384
MAMSI PROVIDER NUMBER
MD
01
9070 0028
BSDC
MD
01
P16991
CAREFIRST POS
MD
Enumeration date
05/05/2006
Last updated
04/10/2013
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