Individual
JEFFREY LEE IDOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
515 CHARLES STREET, LAPLATA, MD 20646
(301) 934-3345
(301) 934-3345
Mailing address
PO BOX 59714, POTOMAC, MD 20859-9714
(301) 934-3345
(301) 934-3345
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
00992
MD
Other
Enumeration date
08/04/2006
Last updated
07/09/2007
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