Provider Demographics
NPI:1114962040
Name:JABAJI, GEORGE J (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:J
Last Name:JABAJI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9114 PHILADELPHIA RD
Mailing Address - Street 2:SUITE 308
Mailing Address - City:ROSEDALE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-4317
Mailing Address - Country:US
Mailing Address - Phone:410-682-4433
Mailing Address - Fax:410-682-4051
Practice Address - Street 1:9114 PHILADELPHIA RD
Practice Address - Street 2:SUITE 308
Practice Address - City:ROSEDALE
Practice Address - State:MD
Practice Address - Zip Code:21237-4317
Practice Address - Country:US
Practice Address - Phone:410-682-4433
Practice Address - Fax:410-682-4051
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0022481174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD798691200Medicaid
MD441302400Medicaid
MD708LMedicare UPIN
MD441302400Medicaid