Provider Demographics
NPI:1194875641
Name:CHIANG, JEANNE T (MD)
Entity type:Individual
Prefix:DR
First Name:JEANNE
Middle Name:T
Last Name:CHIANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2101 EAST JEFFERSON STREET
Mailing Address - Street 2:KAISER PERMANENTE, PPQA, 6 WEST, ATTN: THERESA BROOKS
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852
Mailing Address - Country:US
Mailing Address - Phone:703-531-1792
Mailing Address - Fax:703-536-1550
Practice Address - Street 1:201 N WASHINGTON ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-4518
Practice Address - Country:US
Practice Address - Phone:703-531-1792
Practice Address - Fax:703-531-1792
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0047787207Q00000X
VA0101051911207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
006961M92Medicare ID - Type Unspecified
G16117Medicare UPIN