JAKE VRDOLJAK (NPI# 1619976230) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619976230 |
| Entity Type | Individual |
| Full Name | JAKE VRDOLJAK |
| Other Name | VATROSLAV VRDOLJAK |
| Credential | MD |
| Practice Address |
8926 Woodyard Rd Suite 301 Clinton MD 20735 |
| Mailing Address |
7801 Old Branch Ave Suite 300 Clinton MD 20735 |
| Practice Telephone | 3018563670 |
| Practice Fax Number | 3018680129 |
| Mailing Telephone | 3018566718 |
| Mailing Fax Number | 3018566722 |
| Enumeration Date | 2005-07-15 |
| Last Update Date | 2014-02-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
D0053852 | MD | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
MD31914 | DC | Allopathic & Osteopathic Physicians |
| N | 2085R0205X |
Radiology Specialization: Radiological Physics |
0101222180 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 1619976230 | 05 | |
| MD | 510908600 | 05 | |
| DC | 023794900 | 05 |
| Street Address |
8926 WOODYARD RD SUITE 301 |
| City | CLINTON |
| State | MD |
| Zip Code | 20735 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215933221 | David J Haidak | Internal Medicine | 8926 Woodyard Rd, Ste 201, Clinton, MD 20735-4231 | 2005-06-23 |
| 1003358201 | Diana Carrera | Student in an Organized Health Care Education/Training Program | 8926 Woodyard Rd, Suite 501, Clinton, MD 20735-4220 | 2016-11-06 |
| 1952788580 | National Rehabilitation Hospital, Inc. | Physical Therapist | 8926 Woodyard Rd, Suite 501, Clinton, MD 20735 | 2015-05-04 |
| 1295133528 | Mgmc, LLC | General Practice | 8926 Woodyard Rd, Suite 602, Clinton, MD 20735-4220 | 2014-12-19 |
| 1356740278 | Tosin Fagbemi | Physical Therapist | 8926 Woodyard Rd, Suite 501, Clinton, MD 20735-4220 | 2014-08-15 |
| 1851721773 | Kelli Stewart-johnson | Physical Therapy Assistant | 8926 Woodyard Rd, 701, Clinton, MD 20735-4220 | 2013-11-13 |
| 1548506488 | Chaney Widmer | Genetic Counselor, MS | 8926 Woodyard Rd, Suite 601, Clinton, MD 20735-4220 | 2012-12-21 |
| 1255682589 | Tinsley Simonds Iselin | Physician Assistant | 8926 Woodyard Rd, Suite 701, Clinton, MD 20735-4220 | 2012-09-26 |
| 1174829774 | Luke Johnathan Blankenheim | Physician Assistant | 8926 Woodyard Rd, Suite 701, Clinton, MD 20735-4220 | 2011-01-31 |
| 1821399239 | Timothy Justin Miller | Specialist | 8926 Woodyard Rd, Ste 301, Clinton, MD 20735-4220 | 2010-11-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760940456 | Elise Olson | Occupational Therapist | 9135 Piscataway Rd, Suite 305, Clinton, MD 20735 | 2019-03-12 |
| 1437651742 | Total You Integrative Healthcare Inc | Clinic/Center | 9135 Piscataway Rd Ste 410, Clinton, MD 20735 | 2018-03-02 |
| 1386193233 | Benedicta C Osamor | Home Health Aide | 6808 Purple Lilac Ln, Clinton, MD 20735 | 2016-10-03 |
| 1669926309 | Frankline Ngozi Obi I | Home Health Aide | 8111 Highland Meadows Dr, Clinton, MD 20735 | 2016-08-11 |
| 1770952459 | Adventures One, Inc. | Clinic/Center | 7121 Old Alexandria Ferry Rd., Clinton, MD 20735 | 2015-09-23 |
| 1730574831 | Lindsey Degeorge | Emergency Medicine | 7503 Surratts Rd Dept Of, Clinton, MD 20735 | 2015-04-06 |
| 1316341860 | Margaret Laurence-whitlock | Speech-Language Pathologist | 5807 Terence Dr., Laurence Learning Center, Clinton, MD 20735 | 2014-10-13 |
| 1699103622 | Dcps | Social Worker | 5504 Trout Run Rd, Clinton, MD 20735 | 2013-10-30 |
| 1902232614 | Rafael Antonio Acosta | Dentist | 7905 Malcolm Rd Ste 300, Clinton, MD 20735 | 2013-09-25 |
| 1407135874 | Richelle Wilson Harvey | Occupational Therapist | 8202 Shackelford Way, Clinton, MD 20735 | 2011-08-16 |
| Find all providers in zip 20735 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043587629 | Clifton L Hester Jr. | Radiology | 607 E Leake St, Clinton, MS 39056-4300 | 2011-11-26 |
| 1225101173 | Palmetto Radiology, Pa | Radiology | 22725 Highway 76e, Clinton, SC 29325 | 2006-11-16 |
| 1083664395 | Palmetto Bone & Joint Pa | Radiology | 105 Physicians Park Dr, Clinton, SC 29325-7551 | 2006-05-10 |
| 1003864554 | John P Hamlin | Radiology | 100 N. 30th St, Clinton, OK 73601-3831 | 2006-05-05 |
| 1538157094 | Brian Donnelly | Radiology | 1 Dogwood Drive, Clinton, NJ 08809-0388 | 2005-10-10 |
| 1174521330 | Clinton X-ray Associates, Pa | Radiology | 409 Cooper Dr, Clinton, NC 28328-2817 | 2005-07-12 |
| 1548268709 | Terry Patrick Ginthner | Radiology | 409c Cooper Dr, Clinton, NC 28328-2817 | 2005-07-12 |
| 1568613909 | Angela Maryann Pansera | Radiology | 7801 Old Branch Ave, Ste 300, Clinton, MD 20735-1608 | 2008-10-03 |
| 1851564181 | Austin Luel Jones | Radiology | 1600 N 2nd St, Clinton, MO 64735-1192 | 2008-04-08 |
| 1205039534 | Michael Andrew Gilbert | Radiology | 1600 N 2nd St, Clinton, MO 64735-1192 | 2007-06-06 |
| Find all providers in CLINTON | ||||
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| 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.