DR. JACK J VAN GEFFEN


Address: 2002 Medical Pkwy, Suite 235, Annapolis, MD 21401-3046
Phone: 4102662770

DR. JACK J VAN GEFFEN (NPI# 1487656245) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1487656245
Entity Type Individual
Full Name DR. JACK J VAN GEFFEN
Credential M.D.
Practice Address 2002 Medical Pkwy
Suite 235
Annapolis
MD 21401-3046
Practice Telephone 4102662770
Practice Fax Number 4108416251
Mailing Telephone 4102662770
Mailing Fax Number 4108416251
Enumeration Date 2005-08-11
Last Update Date 2010-11-16
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2085N0904X Radiology
Specialization: Nuclear Radiology
D0019967 MD Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MD BCBS 10690008 01
MD AETNA HMO/POS 2622593 01
MD AAD AA COUNTY JG95 01
MD AAD SHIPLEYS 494M 01
MD TRAVELERS RR MEDICARE 300031317 01
MD AAD PG COUNTY A14 01
MD AETNA PPO 8317071 01
MD MEDICARE SHIPLEYS IMAGING 1487656245 01
MD PTAN DC BOWIE 414894ZED1 01
MD 155951600 05

Office Location

Street Address 2002 MEDICAL PKWY
SUITE 235
City ANNAPOLIS
State MD
Zip Code 21401-3046

Providers in the same location

NPI Name Taxonomy Address Enumeration
1366448953 Ayanna L James Obstetrics & Gynecology 2002 Medical Pkwy, Suite 635, Annapolis, MD 21401-3046 2005-06-28
1336611466 Lauren Mason Social Worker 2002 Medical Pkwy, Annapolis, MD 21401-3046 2018-12-31
1184131542 Amanda Nicole Minnitte Physical Therapy Assistant 2002 Medical Pkwy, Annapolis, MD 21401-3046 2018-01-08
1255878526 Maryland Medicinal LLC Physical Medicine & Rehabilitation 2002 Medical Pkwy, Suite 150, Annapolis, MD 21401-3046 2017-01-25
1669917993 Back To Fit Inc. Physical Medicine & Rehabilitation 2002 Medical Pkwy, 150, Annapolis, MD 21401-3046 2016-12-22
1821549528 Anne Arundel Physician Group, LLC Family Medicine 2002 Medical Pkwy, Suite 460, Annapolis, MD 21401-3046 2016-10-18
1114372497 Anne Arundel Physician Group, LLC Clinical Neuropsychologist 2002 Medical Pkwy, Suite 430, Annapolis, MD 21401-3046 2016-04-25
1487040036 Gaurav Srivastava Ophthalmology 2002 Medical Pkwy, Annapolis, MD 21401-3046 2015-04-10
1164828679 Med-park LLC Pharmacy 2002 Medical Pkwy, Ste 170, Annapolis, MD 21401-3046 2014-11-10
1992147631 Zachary Scott La Fratta Audiologist 2002 Medical Pkwy, Suite 230 Sajak Building, Annapolis, MD 21401-3046 2013-07-23
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1497377154 Michael Khorsandi Student in an Organized Health Care Education/Training Program 2001 Medical Parkway, Clatanoff Pavillon, Gmw Office, Annapolis, MD 21401 2020-05-15
1275172033 Katrice N Nelson Massage Therapist Wellsview Cottage Center, 613 Ridgely Avenue, Annapolis, MD 21401 2019-12-27
1548803521 Victoria Reimnitz Behavioral Analyst 2028 Indusrtrial Dr, Ste B&c, Annapolis, MD 21401 2019-10-23
1700438140 Emily Megan Burke Nurse Practitioner 200 Forbes St Annapolis, Md 21401, Suite 200, Annapolis, MD 21401 2019-07-16
1316504848 Sherina Maryam Shamsa Counselor 1830 Forest Drive, Suite H-2, Annapolis, MD 21401 2019-05-21
1497225288 Jerilyn Deitch Speech-Language Pathologist Anne Arundel County Public Schools, 2644 Riva Rd, Annapolis, MD 21401 2018-12-05
1487124038 Lucinda W Mimms Speech-Language Pathologist 2644 Riva Rd., Annapolis, MD 21401 2018-11-27
1487145496 Michelle Baudean Behavior Technician 1919 West St Ste 201, Annapolis, MD 21401 2018-05-24
1730678954 Stephanie Ruth Streb Registered Nurse 130 Admiral Cochrane Dr Ste 103, Annapolis, MD 21401 2018-05-02
1780183947 Annapolis Sleep Center LLC Clinic/Center 2451 Riva Rd, Annapolis, MD 21401 2018-02-02
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Taxonomy Information

Taxonomy Code 2085N0904X
Grouping Allopathic & Osteopathic Physicians
Classification Radiology
Specialization Nuclear Radiology

Taxonomy Definition

A radiologist who is involved in the analysis and imaging of radionuclides and radiolabeled substances in vitro and in vivo for diagnosis and the administration of radionuclides and radiolabeled substances for the treatment of disease.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1609229228 Reema Goel Radiology 601 N Caroline St # R00m4210, Baltimore, MD 21287-0006 2016-07-19
1114234465 Eram Zaidi Radiology 3716 Bonnybridge Pl, Ellicott City, MD 21043-4115 2010-09-08
1073611901 Martin Y Magram Radiology 3611 Gardenview Rd, Baltimore, MD 21208-1511 2006-09-21
1477586055 Profesional Medical Imaging Solutions LLC Radiology 9900 Franklin Square Dr, Baltimore, MD 21236-5915 2006-07-08
1134128051 Charles Edward Buckley Radiology 4700 Berwyn House Rd, Suite 102, College Park, MD 20740-2474 2005-07-21
1265431324 Harvey Ziessman Radiology 601 N Caroline St, Baltimore, MD 21287-0006 2005-07-20
1497370597 Marshall Kyle Mills Radiology 301 Hospital Dr, Glen Burnie, MD 21061-5803 2020-06-15
1033434808 Diagnostic Imaging, LLC Radiology 1100 Mercantile Ln, Suite 150, Largo, MD 20774-5380 2010-04-05
1750618393 Diagnostic Outpatient Center Radiology 8116 Good Luck Rd, Suite 101, Lanham, MD 20706-3502 2009-11-03
1710157706 Barry Howard Friedman Radiology 201 W Preston St, Baltimore, MD 21201-2301 2008-03-05
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Competitor

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City ANNAPOLIS
Zip Code 21401

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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