Provider Demographics
NPI:1326041179
Name:MALTZ, JONATHAN (MD)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:MALTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3300 OLNEY SANDY SPRING RD STE 330
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-3305
Mailing Address - Country:US
Mailing Address - Phone:301-774-7334
Mailing Address - Fax:301-774-7311
Practice Address - Street 1:3300 OLNEY SANDY SPRING RD STE 330
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-3305
Practice Address - Country:US
Practice Address - Phone:301-774-7334
Practice Address - Fax:301-774-7311
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0021057207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine