Provider Demographics
NPI:1720107931
Name:YANOVSKI, JACK ADAM (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:JACK
Middle Name:ADAM
Last Name:YANOVSKI
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
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Mailing Address - Street 1:12035 MONTROSE VILLAGE TER
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4162
Mailing Address - Country:US
Mailing Address - Phone:301-230-0186
Mailing Address - Fax:301-402-0574
Practice Address - Street 1:10 CENTER DR
Practice Address - Street 2:NIH HATFIELD CRC, RM 1E-3330 MSC 1103
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-1103
Practice Address - Country:US
Practice Address - Phone:301-496-0858
Practice Address - Fax:301-402-0574
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD385352080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology