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Individual

JANA VANDEGRIFT MOHASSEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1475 TANEY AVE STE 201, FREDERICK, MD 21702-5126
(301) 662-1930
(240) 379-6710
Mailing address
2706 CHESWOLDE RD, BALTIMORE, MD 21209-3929
(410) 948-7615

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
D0073806
MD

Other

Enumeration date
04/10/2009
Last updated
03/07/2014
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