Organization
SUSAN E JENKINS, M.D.P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN EILEEN JENKINS M.D. (OWNER)
(240) 460-6044
Entity
Organization
Contact information
Practice address
1450 MERCANTILE LN, SUITE 117, LARGO, MD 20774-5376
(301) 583-0500
Mailing address
1450 MERCANTILE LN, SUITE 117, LARGO, MD 20774-5376
(301) 583-0500
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
D0038258
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1942299417
NPI
—
Enumeration date
08/13/2010
Last updated
09/03/2010
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