Provider Demographics
NPI:1588806616
Name:VAN METER, JONATHAN RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:RICHARD
Last Name:VAN METER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 W MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:NEW MARKET
Mailing Address - State:MD
Mailing Address - Zip Code:21774-6279
Mailing Address - Country:US
Mailing Address - Phone:301-882-8470
Mailing Address - Fax:301-882-8470
Practice Address - Street 1:164 W MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:NEW MARKET
Practice Address - State:MD
Practice Address - Zip Code:21774-6279
Practice Address - Country:US
Practice Address - Phone:301-882-8470
Practice Address - Fax:301-882-8471
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-06
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MDD0075649207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program