Provider Demographics
NPI:1083624522
Name:JOUBERT, AVA G (MD)
Entity Type:Individual
Prefix:DR
First Name:AVA
Middle Name:G
Last Name:JOUBERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:AVA
Other - Middle Name:J
Other - Last Name:CURTIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:13800 MCMULLEN HWY SW
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-5622
Mailing Address - Country:US
Mailing Address - Phone:301-729-7000
Mailing Address - Fax:
Practice Address - Street 1:13800 MCMULLEN HWY SW
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-5622
Practice Address - Country:US
Practice Address - Phone:301-729-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0032947207KA0200X
MDD32947207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy