1932136926 NPI number — DR. RYAN MICHAEL JANDER M.D.

Table of content: DR. SAMIYA RAZZAQ MD (NPI 1053401612)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932136926 NPI number — DR. RYAN MICHAEL JANDER M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JANDER
Provider First Name:
RYAN
Provider Middle Name:
MICHAEL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

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:
1932136926
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/28/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8926 WOODYARD ROAD
Provider Second Line Business Mailing Address:
SUITE 701
Provider Business Mailing Address City Name:
CLINTON
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20735
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-856-1682
Provider Business Mailing Address Fax Number:
301-856-0964

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8926 WOODYARD ROAD
Provider Second Line Business Practice Location Address:
SUITE 701
Provider Business Practice Location Address City Name:
CLINTON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20735
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-856-1682
Provider Business Practice Location Address Fax Number:
301-856-0964
Provider Enumeration Date:
06/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X , with the licence number:  D0064678 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207X00000X , with the licence number: 0101239951 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207X00000X , with the licence number: MD036127 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207XS0106X , with the licence number: D0064678 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207XS0106X , with the licence number: 0101239951 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 238582 . This is a "ANTHEM PROVIDER #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 46950028 . This is a "BCBS NCA PROVIDER#" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 52 1054342 . This is a "GMO GROUP TAX ID #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 176608 . This is a "METRO MEDICARE GMO GRP#" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: P00457403 . This is a "RAIL ROAD MEICARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 5722200 . This is a "FIRST HEALTH PROVIDER#" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0458905 . This is a "CIGNA PROVIDER #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 763904 . This is a "NCPPO PROVIDER#" identifier . This identifiers is of the category "OTHER".
  • Identifier: 238578 . This is a "ANTHEM PROVIDER #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 462LQ643 . This is a "MARYLAND MEDICARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 1359236 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 238575 . This is a "ANTHEM PROVIDER #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7799886 . This is a "AETNA PPO PROVIDER#" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00457403 . This is a "RAIL ROAD MEDICARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 892834 . This is a "BCBS MD INDIV PROV#" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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