Individual
IRENE MARGARET VANGSNESS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
803 RUSSELL AVE, SUITE # 1 SMC, GAITHERSBURG, MD 20879-3584
(301) 869-0700
(301) 947-9513
Mailing address
15 TURNHAM CT, GAITHERSBURG, MD 20878-2619
(301) 838-1991
(301) 947-9513
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0000827
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1011307
NCCPA CERT#
MD
01
—
C0000827
MARYLAND CERT #
MD
Enumeration date
06/15/2006
Last updated
07/08/2007
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