Individual
SUSAN MARIE JAGT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
655 WATKINS MILL RD, GAITHERSBURG, MD 20879-3301
(240) 632-4454
Mailing address
655 WATKINS MILL RD, GAITHERSBURG, MD 20879-3301
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
228718
MD
Other
Enumeration date
01/27/2020
Last updated
01/27/2020
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