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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 |
