Provider Demographics
NPI:1225548522
Name:THURMAN, JEREMY
Entity Type:Individual
Prefix:
First Name:JEREMY
Middle Name:
Last Name:THURMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19851 OBSERVATION DR
Mailing Address - Street 2:STE 450
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-4148
Mailing Address - Country:US
Mailing Address - Phone:301-977-6777
Mailing Address - Fax:301-977-0108
Practice Address - Street 1:19851 OBSERVATION DR STE 450
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-4148
Practice Address - Country:US
Practice Address - Phone:301-977-6777
Practice Address - Fax:301-977-0108
Is Sole Proprietor?:No
Enumeration Date:2017-10-02
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD26672225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist