Jennifer Christie Gourdin
Family Doctor - Sports Medicine
1221 Mercantile Ln
Upper Marlboro
, Maryland 20774-5374
Jennifer Christie Gourdin
Family Doctor - Sports Medicine
1221 Mercantile Ln
Upper Marlboro
, Maryland 20774-5374
(301) 816-5853
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About
Features
Specialties
- Family Doctor - Sports Medicine
Languages spoken
- English
Location
First Address
- Jennifer Christie Gourdin
- 2101 E Jefferson St Ste 6w
- Rockville, MD
- Zip : 20852-4908
- Phone : (301) 816-5853
Second Address
- Jennifer Christie Gourdin
- 1221 Mercantile Ln
- Upper Marlboro, MD
- Zip : 20774-5374
- Phone : (301) 618-5500
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207QS0010X | Family Doctor - Sports Medicine | D82925 | MD |
National Provider Identifier
| NPI | 1194168385 |
|---|---|
| Provider Name | Jennifer Christie Gourdin |
| First Address | Rockville, MD 20852-4908 |
| Second Address | Upper Marlboro, MD 20774-5374 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 08/04/2013 |
| Last Update Date | 22/11/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.