Pothast, Jason

Pothast, Jason is an individual health care provider with primary practice located at 18109 Prince Philip Dr Suite 155, Olney MD 20832-1519. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Pothast, Jason can be contacted via phone (301) 570-7415.

Contact Information

Primary practice address
18109 Prince Philip Dr Suite 155 Olney MD 20832-1519
Phone: (301) 570-7415
Fax: (301) 570-7416
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 2081S0010X D0078451 Maryland

Profile Details

NPI number 1508003971
LBN Legal business name Pothast, Jason
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 7th, 2009
Last updated Jul 21st, 2022 - about 3 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 1508003971 NPPES
New Jersey MEDICAID 0308871
New Jersey MEDICAID 102738394

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