John Kijak Jr MD PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

JOHN KIJAK JR MD PA

Practice address

9815 Main St
Suite 41
Damascus, MD 20872-2002

Phone

(301) 253-4004

Fax

(301) 253-3391

NPI assigned

Jul 6, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Linda Phelps Hanan

Title

Office Manager

Phone

(301) 253-4004

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Maryam Farazha, MD

  • Family Medicine Physician
  • Santa Monica, CA
  • NPI 1063416840
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720010333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9815 MAIN ST",
            "address_2": "SUITE 41",
            "city": "DAMASCUS",
            "state": "MD",
            "postal_code": "208722002",
            "telephone_number": "301-253-4004",
            "fax_number": "301-253-3391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9815 MAIN ST",
            "address_2": "SUITE 41",
            "city": "DAMASCUS",
            "state": "MD",
            "postal_code": "208722002",
            "telephone_number": "301-253-4004",
            "fax_number": "301-253-3391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN KIJAK JR MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HANAN",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "PHELPS",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "301-253-4004"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ganeshan S Iyer
• Megan Joesting
• Bryan Taekyung Jung, DDS
• Robert Bernard Kaufman, M.D.
• Ranta Kibbe
• Samantha Hyunkyung Kim, MA
• Branden Klahre

• Family Medicine Physician in Damascus, MD
• Providers in Damascus, MD by specialty
• Family Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.