Individual provider · Type 1 NPI

Jericho De Mata, DO

Family Medicine Physician · Upper Marlboro, MD

NPI number 1275950396 Active

Practice location

1221 Mercantile Ln
Upper Marlboro, MD 20774-5374

Mailing address

2101 E Jefferson St Ste 6W
Rockville, MD 20852-4908

Specialties and licenses

TaxonomyCodeLicense
Family Medicine Physician Primary 207Q00000XH83783 (MD)
Family Medicine Physician 207Q00000X0102205000 (VA)
Family Medicine Physician 207Q00000XMD045539 (DC)

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

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About NPI 1275950396

Jericho De Mata, DO's National Provider Identifier is 1275950396, issued on Mar 26, 2014. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Upper Marlboro, MD. The record was last updated on Aug 11, 2026.