Individual
MS. JEANINE MACKIEWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, MMS
Contact information
Practice address
1500 FOREST GLEN RD, SILVER SPRING, MD 20910-1460
(301) 754-7230
(301) 754-7228
Mailing address
1500 FOREST GLEN RD, SILVER SPRING, MD 20910-1460
(301) 754-7230
(301) 754-7228
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
C0005595
MD
Other
Enumeration date
11/06/2014
Last updated
05/12/2017
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