Provider Demographics
NPI:1588783047
Name:JACKMAN, NIGEL ERIC (MD)
Entity type:Individual
Prefix:DR
First Name:NIGEL
Middle Name:ERIC
Last Name:JACKMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3003 HOSPITAL DRIVE
Mailing Address - Street 2:SUITE #1055
Mailing Address - City:CHEVERLY
Mailing Address - State:MD
Mailing Address - Zip Code:20785-1196
Mailing Address - Country:US
Mailing Address - Phone:301-583-3741
Mailing Address - Fax:301-583-3734
Practice Address - Street 1:3003 HOSPITAL DRIVE
Practice Address - Street 2:SUITE #1055
Practice Address - City:CHEVERLY
Practice Address - State:MD
Practice Address - Zip Code:20785-1196
Practice Address - Country:US
Practice Address - Phone:301-583-3741
Practice Address - Fax:301-583-3734
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0023830207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine