Basic Information
| Provider Information | |||||||||
| NPI: | 1194923193 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JEAN | ||||||||
| FirstName: | DANIELLE | ||||||||
| MiddleName: | SAINT ULME | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3323 BEAVERWOOD LN | ||||||||
| Address2: | |||||||||
| City: | SILVER SPRING | ||||||||
| State: | MD | ||||||||
| PostalCode: | 209063064 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018710658 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3301 WILSON BLVD | ||||||||
| Address2: | |||||||||
| City: | ARLINGTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 22201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7032436720 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2007 | ||||||||
| LastUpdateDate: | 10/04/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MT-191647 | PA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | MD038695 | DC | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | D0071987 | MD | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 0101250587 | VA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.