IndividualActive
Jacqueline Durst, ATC, LAT
NPI 1003203068 · Sports Medicine (Emergency Medicine) Physician · Frostburg, MD
Provider details
- NPI number
- 1003203068
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Emergency Medicine) PhysicianAllopathic & Osteopathic Physicians
- Credential
- ATC, LAT
- Sex
- Female
- Sole proprietor
- No
- License
- A00192 (MD)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
101 Braddock Rd
Frostburg State University Kinesiology Department
Frostburg, MD 21532-2303
Phone: (301) 697-2801
Approximate (ZIP-level) locationGet directions
Mailing address
27 Frost Ave
Frostburg, MD 21532-1623
Registry dates
- Enumerated
- 2015-04-16
- Last updated
- 2015-04-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.