Provider Demographics
NPI:1497744205
Name:SOLOMON, JONATHAN DAVID (MD)
Entity Type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:DAVID
Last Name:SOLOMON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:7500 HANOVER PKWY
Mailing Address - Street 2:STE 101B
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2010
Mailing Address - Country:US
Mailing Address - Phone:301-982-4565
Mailing Address - Fax:301-982-4252
Practice Address - Street 1:7500 HANOVER PKWY
Practice Address - Street 2:STE 101B
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-2010
Practice Address - Country:US
Practice Address - Phone:301-982-4565
Practice Address - Fax:301-982-4252
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2010-07-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0061149207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I06530Medicare UPIN
014203S61Medicare ID - Type Unspecified