Individual
DR. JACK J VAN GEFFEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2002 MEDICAL PKWY, SUITE 235, ANNAPOLIS, MD 21401-3046
(410) 266-2770
(410) 841-6251
Mailing address
2002 MEDICAL PKWY, SUITE 235, ANNAPOLIS, MD 21401-3046
(410) 266-2770
(410) 841-6251
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
Primary
D0019967
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10690008
BCBS
MD
01
—
1487656245
MEDICARE SHIPLEYS IMAGING
MD
05
—
155951600
—
MD
01
—
2622593
AETNA HMO/POS
MD
01
—
300031317
TRAVELERS RR MEDICARE
MD
01
—
414894ZED1
PTAN DC BOWIE
MD
01
—
494M
AAD SHIPLEYS
MD
01
—
8317071
AETNA PPO
MD
01
—
A14
AAD PG COUNTY
MD
01
—
JG95
AAD AA COUNTY
MD
Enumeration date
08/11/2005
Last updated
11/16/2010
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