Individual
DR. KAVITA SRIVASTAVA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1500 FOREST GLEN RD DEPT OF, SILVER SPRING, MD 20910-1460
(301) 754-7000
Mailing address
1500 FOREST GLEN RD, DEPT OF EMERGENCY MEDICINE, SILVER SPRING, MD 20910-1484
(301) 754-7000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
D0086968
MD
390200000X
Student in an Organized Health Care Education/Training Program
MT209033
PA
Other
Enumeration date
06/12/2015
Last updated
06/19/2019
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