Individual
THERESA DONOHUE JERUSSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, PA-C
Contact information
Practice address
10 CENTER DRIVE MSC 1202, BUILDING 10, CRC RM 3-5272, BETHESDA, MD 20892-0001
(301) 594-8003
(301) 480-0195
Mailing address
10 CENTER DRIVE MSC 1202, BUILDING 10, CRC RM 3-5272, BETHESDA, MD 20892-0001
(301) 594-8003
(301) 480-0195
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0002298
MD
Other
Enumeration date
09/10/2008
Last updated
04/02/2012
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