Provider Demographics
NPI:1700864501
Name:ADELSON, JONATHAN MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:MARK
Last Name:ADELSON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7300 HANOVER DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2202
Mailing Address - Country:US
Mailing Address - Phone:301-345-5600
Mailing Address - Fax:301-345-3105
Practice Address - Street 1:7300 HANOVER DR
Practice Address - Street 2:SUITE 201
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-2202
Practice Address - Country:US
Practice Address - Phone:301-345-5600
Practice Address - Fax:301-345-3105
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2010-12-30
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Provider Licenses
StateLicense IDTaxonomies
MDD24234207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD315191300Medicaid
MDC57811Medicare UPIN