Deborah A. Jack MD - Internal Medicine Physician in Silver Spring, Maryland | ProviderWire

Full Name

Deborah Anthony Jack MD

NPI Number

1750919924

NPI Type

Individual Provider

Gender

Female

Enumeration Date

03/31/2020

Specialties

(Taxonomies)

Name

Internal Medicine Physician

Student in an Organized Health Care Education/Training Program

Code

207R00000X

390200000X

Primary Taxonomy

Yes

No

Licenses

State

Maryland

License Number

D0097198

Contact
Information

Purpose

Mailing

Location

Address

11013 LAKE VICTORIA LN

11890 HEALING WAY

City

Bowie

Silver Spring

State

MD

MD

Postal Code

20720-4272

20904-7917

Country

US

US

Telephone Number

(240) 281-9613

(240) 637-4000

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 06/18/2023

Provider Address

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