Linda M. Jefferson, Md Pa | |
2670 Crain Hwy Suite 410 Waldorf MD 20601-2806 | |
(301) 374-9300 | |
(301) 374-9469 |
Full Name | Linda M. Jefferson, Md Pa |
---|---|
Speciality | Family Medicine |
Location | 2670 Crain Hwy, Waldorf, Maryland |
Authorized Official Name and Position | Linda M Jefferson (CEO) |
Authorized Official Contact | 3013749300 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Linda M. Jefferson, Md Pa 2670 Crain Hwy Suite 410 Waldorf MD 20601-2806 Ph: (301) 374-9300 | Linda M. Jefferson, Md Pa 2670 Crain Hwy Suite 410 Waldorf MD 20601-2806 Ph: (301) 374-9300 |
NPI Number | 1922295237 |
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Provider Enumeration Date | 10/01/2007 |
Last Update Date | 06/22/2016 |
Medicare PECOS PAC ID | 0941266399 |
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Medicare Enrollment ID | O20041207000831 |
Identifier | Type | State | Issuer |
---|---|---|---|
1922295237 | NPI | - | NPPES |
332602100 | Medicaid | MD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | D0054004 (Maryland) | Primary |
Provider Name | Linda Jefferson |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1164415832 PECOS PAC ID: 6103882568 Enrollment ID: I20110818000489 |
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