Basic Information
| Provider Information | |||||||||
| NPI: | 1003006586 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MAREEDU | ||||||||
| FirstName: | JYOTSNA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2208 KERRYDALE CT | ||||||||
| Address2: | |||||||||
| City: | CLARKSBURG | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208713366 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2404996136 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1500 FOREST GLEN RD | ||||||||
| Address2: | |||||||||
| City: | SILVER SPRING | ||||||||
| State: | MD | ||||||||
| PostalCode: | 209101460 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3017547000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/31/2007 | ||||||||
| LastUpdateDate: | 06/19/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | D71796 | MD | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.