Organization
JAYANTHAN.M.D.,P.A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NIRMALADEVI JAYANTHAN (PRESIDENT)
(301) 932-4954
Entity
Organization
Contact information
Practice address
3328 OLD WASHINGTON RD, WALDORF, MD 20602-3204
(301) 932-4954
(301) 932-5095
Mailing address
3328 OLD WASHINGTON RD, WALDORF, MD 20602-3204
(301) 932-4954
(301) 932-5095
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D45737
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
400866900
—
MD
Enumeration date
04/17/2008
Last updated
03/06/2009
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