MEDICARE: MARIE C CHOPPIN

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
1	1041C0700X	Clinical Social Worker	10046	MD

General Provider Information

NPI Number	:	1326083353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIE C CHOPPIN

Provider Business Mailing Address
First Line	:	12600 PENTENVILLE RD
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-3525
Country	:	US
Telephone Number	:	301-625-9102
Fax Number	:	866-445-3249

Provider Business Practice Location Address
First Line	:	8830 CAMERON CT
Second Line	:	SUITE 101
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-4114
Country	:	US
Telephone Number	:	301-625-9102
Fax Number	:	866-445-3249

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2006
Last Update Date	:	03/12/2008

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