Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | D0056923 | MD |
NPI | 1013020718 |
---|---|
Provider Name | Jane M. Lingelbach |
First Address | Rockville, MD 20852-2917 |
Second Address | Takoma Park, MD 20912-6323 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2006 |
Last Update Date | 01/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4034961 00 | (05) | MD |
G57741 | (02) |