Individual
DR. JACQUELYN LORRAINE REDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1396 PICCARD DR, KAISER PERMANENTE SHADY GROVE MEDICAL CENTER, ROCKVILLE, MD 20850-4302
(301) 548-5700
Mailing address
2101 E JEFFERSON ST, KAISER PERMANENTE MEDICARE ENROLLMENT, ROCKVILLE, MD 20852-4908
(301) 816-2424
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
0101056903
VA
207RG0100X
Gastroenterology Physician
Primary
D0039754
MD
207RG0100X
Gastroenterology Physician
MD20775
DC
Other
Enumeration date
12/12/2006
Last updated
06/11/2021
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