Provider Demographics
NPI:1821008897
Name:DESCHAMPS, JEFFERY S (DC)
Entity type:Individual
Prefix:DR
First Name:JEFFERY
Middle Name:S
Last Name:DESCHAMPS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 THOMAS JOHNSON DR
Mailing Address - Street 2:STE 8
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4442
Mailing Address - Country:US
Mailing Address - Phone:301-663-8707
Mailing Address - Fax:301-663-6700
Practice Address - Street 1:198 THOMAS JOHNSON DR
Practice Address - Street 2:STE 8
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4442
Practice Address - Country:US
Practice Address - Phone:301-663-8707
Practice Address - Fax:301-663-6700
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01090111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR0450001OtherFEDERAL BCBS
MD441835OtherUNITED HEALTHCARE
MD27253OtherMAMSI ALLIANCE
MDM188OtherCAREFIRST BCBS
MD441835OtherUNITED HEALTHCARE
T59547Medicare UPIN