Provider Demographics
NPI:1831139062
Name:MONEYHUN, JEANNE RENEE (MD)
Entity type:Individual
Prefix:
First Name:JEANNE
Middle Name:RENEE
Last Name:MONEYHUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9420 KEY WEST AVE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3334
Mailing Address - Country:US
Mailing Address - Phone:301-315-2111
Mailing Address - Fax:301-315-5866
Practice Address - Street 1:9420 KEY WEST AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3334
Practice Address - Country:US
Practice Address - Phone:301-315-2111
Practice Address - Fax:301-315-5866
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD41871174400000X
MDD0041871207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0843113 00Medicaid
MDF05407Medicare UPIN
MD00B960E83Medicare ID - Type Unspecified