Provider Demographics
NPI:1467774729
Name:JEON, JANICE YOONMI (MD)
Entity Type:Individual
Prefix:DR
First Name:JANICE
Middle Name:YOONMI
Last Name:JEON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JANICE
Other - Middle Name:YOONMI
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8030 CRIANZA PL
Mailing Address - Street 2:APT. 242
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-4090
Mailing Address - Country:US
Mailing Address - Phone:917-886-1884
Mailing Address - Fax:
Practice Address - Street 1:22 S. GREENE STREET
Practice Address - Street 2:DEPT OF RADIOLOGY
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201
Practice Address - Country:US
Practice Address - Phone:410-328-3477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-26
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00733722085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology