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Dr. Jeffrey S Dome

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NPI Number Detailed Information

Provider Information:

Name: Dr. Jeffrey S Dome
Gender: M
Provider License Number If Given: MD036384

NPI Information:

NPI: 1902809197
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 5/23/2005

Last Update Date: 10/29/2012

Provider Business Mailing Address:

Address: PO BOX 37215
Baltimore, MD 21297
Phone Number:
Fax Number:

Provider Business Practice Location Address:

Address: 111 MICHIGAN AVE NW CHILDREN'S NATIONAL MEDICAL CENTER
Washington, DC 20010
Phone Number: 2024762800
Fax Number: 2024765685

Provider Taxonomy:

Primary: 2080P0207X
Secondary (if any):
State: DC

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