Provider Demographics
NPI:1104961010
Name:VOYADZIS, JEAN-MARC (MD)
Entity type:Individual
Prefix:DR
First Name:JEAN-MARC
Middle Name:
Last Name:VOYADZIS
Suffix:
Gender:M
Credentials:MD
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 418283
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-8283
Mailing Address - Country:US
Mailing Address - Phone:703-558-1544
Mailing Address - Fax:
Practice Address - Street 1:10401 HOSPITAL DR
Practice Address - Street 2:SUITE 101
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-3110
Practice Address - Country:US
Practice Address - Phone:301-856-2323
Practice Address - Fax:301-856-5619
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD33327207T00000X
MDD0065968207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCP00856500OtherRAILROAD MEDICARE
DC021839YT2Medicare PIN
MD206630ZBRPMedicare PIN