DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: CCDC PROFESSIONALS, LLC

MEDICARE: CCDC PROFESSIONALS, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse Anesthetist
21223D0004XDental Anesthesiology
3207LP3000XPediatric Anesthesiology Physician
4207L00000XAnesthesiology Physician

General Provider Information

NPI Number : 1205542214
Entity Type Code : Organization
Provider Name (Legal Business Name) : CCDC PROFESSIONALS, LLC
Provider Business Mailing Address
First Line : 1220 CARAWAY CT STE 1050
Second Line :
City : UPPER MARLBORO
State : MD
Zip : 20774-5338
Country : US
Telephone Number : 301-494-3000
Fax Number :
Provider Business Practice Location Address
First Line : 1220 CARAWAY CT STE 1050
Second Line :
City : UPPER MARLBORO
State : MD
Zip : 20774-5338
Country : US
Telephone Number : 301-494-3000
Fax Number :
Authorized Official
Title or Position : BUSINESS MANAGER
Name : JEFFREY WHEELER
Credential :
Telephone Number : 301-494-3000
Provider Enumeration Date : 01/24/2023
Last Update Date : 01/13/2026

Similar Medicare Providers

1285184218 — CCDC PROFESSIONALS, LLC
Practice Location Address:
1220 CARAWAY CT STE 1050
UPPER MARLBORO, MD
20774-5338
Practice Phone: 301-494-3000
Practice Fax: 301-494-3333
1316484447 — CAPITAL CHILDREN'S HEALTHCARE
Practice Location Address:
1220 CARAWAY CT STE 1050
UPPER MARLBORO, MD
20774-5338
Practice Phone: 301-494-3000
Practice Fax:
1659817781 — CAPITAL CHILDREN'S SURGICAL CENTER, LLC
Practice Location Address:
1220 CARAWAY CT STE 1050
UPPER MARLBORO, MD
20774-5338
Practice Phone: 301-494-3000
Practice Fax: 301-494-3333
1699252544 — GREEN STATES ANESTHESIA PLLC
Practice Location Address:
1220 CARAWAY CT STE 1050
UPPER MARLBORO, MD
20774-5338
Practice Phone: 800-783-8584
Practice Fax: 800-783-8584
1578030193 — SANDMAN, LLC
Practice Location Address:
1220 CARAWAY CT STE 1050
UPPER MARLBORO, MD
20774-5338
Practice Phone: 301-494-3000
Practice Fax:
1609433903 — DR. ERICA D SIMMS DDS
Practice Location Address:
1220 CARAWAY CT STE 1050
UPPER MARLBORO, MD
20774-5338
Practice Phone: 301-494-3000
Practice Fax:

Directions to “CCDC PROFESSIONALS, LLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.