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Individual

JACQUELYN B. DUNMORE-GRIFFITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
8116 GOOD LUCK RD STE LL05, LANHAM, MD 20706-3502
(240) 542-3060
(240) 542-3061
Mailing address
PO BOX 418837, BOSTON, MA 02241-8837
(240) 542-3060
(240) 542-3061

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
D0046901
MD
2085R0001X
Radiation Oncology Physician
MD20575
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0002
BCBS DC
MD
05
011624500
DC
01
01178473
AMERIGROUP PROVIDER #
MD
05
500000901
MD
01
621105-03
BCBS MD
MD
05
714014200
MD
01
P00458394
RAILROAD MEDICARE
MD
Enumeration date
03/02/2006
Last updated
02/28/2022
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