Individual
MALCOLM XAVIER JEFFERIES SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4 ROLLING CROSSROADS, CATONSVILLE, MD 21228
(410) 869-3344
Mailing address
638 FREDERICK RD, CATONSVILLE, MD 21228-4625
(443) 414-9573
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R211193
MD
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
MD
01
—
NONE
NONE
—
Enumeration date
12/20/2021
Last updated
05/20/2024
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