Colburn, Jessica Leigh

Colburn, Jessica Leigh is an individual health care provider with primary practice located at 301 Mason Lord Dr , Baltimore MD 21224-3057. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Geriatric Medicine. Allopathic & Osteopathic Physicians / Geriatric Medicine is her primary health care specialty. Colburn, Jessica Leigh can be contacted via phone (410) 550-3350.

Contact Information

Primary practice address
301 Mason Lord Dr Baltimore MD 21224-3057
Phone: (410) 550-3350
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X D67635 Maryland

Profile Details

NPI number 1548311830
LBN Legal business name Colburn, Jessica Leigh
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 15th, 2007
Last updated Oct 5th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548311830 NPPES
Maryland MEDICAID 018306700

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