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Individual

JASON J JANCOSKO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O., M.P.T.

Contact information

Practice address
510 IDLEWILD AVE, EASTON, MD 21601-3881
(410) 820-8226
(410) 820-8405
Mailing address
510 IDLEWILD AVE, EASTON, MD 21601-3881
(410) 820-8226
(410) 820-8405

Taxonomy

Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
H75947
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4458265 00
MD
01
CF170008
CAREFIRST
MD
Enumeration date
05/04/2009
Last updated
07/01/2016
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