Provider Demographics
NPI:1013020718
Name:LINGELBACH, JANE M (MD)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:M
Last Name:LINGELBACH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5811 EDSON LN
Mailing Address - Street 2:# 101
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-2917
Mailing Address - Country:US
Mailing Address - Phone:240-396-4871
Mailing Address - Fax:301-270-7249
Practice Address - Street 1:7610 CARROLL AVE STE 380
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-6323
Practice Address - Country:US
Practice Address - Phone:240-396-4871
Practice Address - Fax:301-270-7249
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2018-05-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD00569232086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4034961 00Medicaid
G57741Medicare UPIN
MD4034961 00Medicaid