Individual
BENJAMIN JACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
8901 ROCKVILLE PIKE, BETHESDA, MD 20889-5095
(301) 295-4959
Mailing address
8901 ROCKVILLE PIKE, BETHESDA, MD 20889-5095
(301) 295-4959
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0102206835
VA
Other
Enumeration date
03/10/2020
Last updated
05/15/2025
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