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Individual

JOSE L MENDOZA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
8926 WOODYARD RD, SUITE 201, CLINTON, MD 20735-4220
(301) 868-7911
(301) 868-2285
Mailing address
8926 WOODYARD RD, SUITE 201, CLINTON, MD 20735-4220
(301) 868-7911
(301) 868-2285

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
D0064153
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
021213000
MD
01
02810007
BC/BS OF DC
DC
05
037955300
DC
01
1293056
AETNA HMO
01
3154546
MAMSI
01
5258642
CIGNA
01
88874601
BC/BS MD - CLINTON
MD
01
88874602
BC/BS MD - GREENBELT
MD
01
B6480006
BC/BS OF DC
DC
Enumeration date
06/16/2006
Last updated
05/14/2008
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