Provider Demographics
NPI:1629067350
Name:GOULD, JED D (MD)
Entity Type:Individual
Prefix:DR
First Name:JED
Middle Name:D
Last Name:GOULD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1400 FOREST GLEN ROAD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-1459
Mailing Address - Country:US
Mailing Address - Phone:301-681-6772
Mailing Address - Fax:301-681-0346
Practice Address - Street 1:1400 FOREST GLEN ROAD
Practice Address - Street 2:SUITE 500
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-1459
Practice Address - Country:US
Practice Address - Phone:301-681-6772
Practice Address - Fax:301-681-0346
Is Sole Proprietor?:No
Enumeration Date:2005-10-15
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0017298207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD0017298OtherMEDICAL LICENSE
DC017326O66Medicare PIN
MDD0017298OtherMEDICAL LICENSE