Provider Demographics
NPI:1730231218
Name:JABER, ADEEB (MD)
Entity type:Individual
Prefix:DR
First Name:ADEEB
Middle Name:
Last Name:JABER
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 64916
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4916
Mailing Address - Country:US
Mailing Address - Phone:443-481-6482
Mailing Address - Fax:443-481-6515
Practice Address - Street 1:2001 MEDICAL PKWY
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3280
Practice Address - Country:US
Practice Address - Phone:443-481-1000
Practice Address - Fax:443-481-1687
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC175562207R00000X
MDD60390208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCC0410030OtherCAREFIRST OF DC
145724700OtherFEDERAL WORKMAN'SCOMP/DEPT. OF LABOR
MD5852640OtherAETNA NON-HMO
S3990052OtherBCBS
1923212OtherAETNA HMO
MD3351822OtherAETNA HMO
MD402715900Medicaid
MDP00041274OtherRAILROAD MEDICARE
126367OtherJOHNS HOPKINS HC
MD2116531OtherMAMSI HMO
MD62041401OtherCAREFIRST OF MARYLAND
62041404OtherBCBS
5852640OtherAETNA PPO
MD5852640OtherAETNA NON-HMO
5852640OtherAETNA PPO
P00821624Medicare PIN
MD62041401OtherCAREFIRST OF MARYLAND