Individual
DR. PATRICIA POLK JETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
129 LUBRANO DR, SUITE 100, ANNAPOLIS, MD 21401-7566
(410) 266-5852
(410) 266-5095
Mailing address
1111 BENFIELD BLVD, SUITE 200, MILLERSVILLE, MD 21108-3002
(410) 729-5100
(410) 729-5156
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D50756
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
031003
JHHC PROVIDER NUMBER
MD
01
—
0597124
AETNA CAPITATED
MD
01
—
080093090
RAILROAD MEDICARE
MD
01
—
2171119
CIGNA PROVIDER NUMBER
MD
01
—
260241
MAMSI SPECIALIST
MD
05
—
452011400
—
MD
01
—
544390-02
CAREFIRST RENDERING
MD
01
—
5743200
AETNA FEE FOR SERVICE
MD
01
—
7605-0014
CAREFIRST BLUECHOICE
MD
01
—
860241
MAMSI PRIMARY CARE
MD
01
—
P14116
CAREFIRST MPOS
MD
Enumeration date
08/09/2005
Last updated
05/24/2012
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