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Dr. Jerry Wendell McConnell, M.D.

Internal Medicine in Largo, MD. Individual provider (NPI-1).

NPI number1124174875
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1124174875
Entity type
Individual (NPI-1)
Name
Dr. Jerry Wendell McConnell
Credential
M.D.
Sex
Male
Sole proprietor
No
Enumeration date
Jan 26, 2007
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal MedicineD29654MDYes
207R00000X Internal MedicineMD13716DC

Practice location

1221 Mercantile Lane
Largo, MD 20774

Phone 301-618-5578 · Fax 301-618-5673

Mailing address

2101 East Jefferson Street
Kaiser Permanente, Ppqa, 6 West, Attn: Theresa Brooks
Rockville, MD 20852

Phone 301-816-6660 · Fax 301-816-6308

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