Provider Demographics
NPI:1063156214
Name:JAIN, MEERA
Entity type:Individual
Prefix:
First Name:MEERA
Middle Name:
Last Name:JAIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 769
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20830-0769
Mailing Address - Country:US
Mailing Address - Phone:301-598-4500
Mailing Address - Fax:877-673-9657
Practice Address - Street 1:3801 INTERNATIONAL DR STE 205
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-1550
Practice Address - Country:US
Practice Address - Phone:301-598-4500
Practice Address - Fax:877-673-9657
Is Sole Proprietor?:No
Enumeration Date:2022-04-25
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MDD0103487207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program