Provider Demographics
NPI:1710685888
Name:GEORGE, JUBY MARIAM
Entity Type:Individual
Prefix:
First Name:JUBY
Middle Name:MARIAM
Last Name:GEORGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1619 SPOTTSWORTH WAY
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20905-7041
Mailing Address - Country:US
Mailing Address - Phone:240-731-4343
Mailing Address - Fax:
Practice Address - Street 1:1619 SPOTTSWORTH WAY
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20905-7041
Practice Address - Country:US
Practice Address - Phone:240-731-4343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program