JERICHO DE MATA, D.O.

Family Medicine

Active Individual
NPI: 1275950396

Practice Address

1221 MERCANTILE LN
Upper Marlboro, MD 20774

Phone: (301) 618-5500

Specialties

Specialty Code Primary License
Family Medicine 207Q00000X Yes H83783 (MD)

Frequently Asked Questions

NPI 1275950396 is the National Provider Identifier for JERICHO DE MATA, D.O., a Family Medicine provider located in Upper Marlboro, MD. This NPI was enumerated on March 26, 2014.
JERICHO DE MATA, D.O. practices at 1221 MERCANTILE LN, Upper Marlboro, MD 20774.

Quick Facts

NPI
1275950396
Type
Individual
Enumerated
Mar 26, 2014
Last Updated
Jun 20, 2021

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