Organization
MARIA L JISON MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIA LEONOR JISON MD (OWNER)
(301) 717-7912
Entity
Organization
Contact information
Practice address
11006 VEIRS MILL RD, PMB 261, WHEATON, MD 20902-2582
(240) 489-6262
(240) 489-6262
Mailing address
11006 VEIRS MILL RD, PMB 261, WHEATON, MD 20902-2582
(240) 489-6262
(240) 489-6262
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
D0054450
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1326080193
INDIVIDUAL NPI
MD
Enumeration date
08/14/2006
Last updated
09/04/2012
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