1073725776 NPI number — JATINDER S. SEKHON, MD, PC

Table of content: (NPI 1073725776)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073725776 NPI number — JATINDER S. SEKHON, MD, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JATINDER S. SEKHON, MD, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1073725776
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/09/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11805 CENTURION WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
POTOMAC
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20854-6419
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10110 MOLECULAR DR
Provider Second Line Business Practice Location Address:
SUITE 109
Provider Business Practice Location Address City Name:
ROCKVILLE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20850-7538
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-417-9528
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/04/2007

Additional Information

Authorized Official

Authorized Official Last Name:
VOGLEZON
Authorized Official First Name:
LAURELL
Authorized Official Middle Name:
Authorized Official Title or Position:
BILLING DEPT SUPERVISOR
Authorized Official Telephone Number:
301-982-2441

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  D0051714 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 840821100 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2105409 . This is a "ALLIANCE ONE NET" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 72217 . This is a "AMERIGROUP" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 840821101 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3318 . This is a "CAREFIRST BCBS - DC" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 0S43JS . This is a "CAREFIRST BCBS - MD" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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