MEDICARE: CHARLES JOHN AKODA M.D.

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	207V00000X	Obstetrics & Gynecology Physician	D0073049	MD

General Provider Information

NPI Number	:	1952664278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLES JOHN AKODA M.D.

Provider Business Mailing Address
First Line	:	6005 LANDOVER ROAD, SUITE 5
Second Line	:
City	:	CHEVERLY
State	:	MD
Zip	:	20785
Country	:	US
Telephone Number	:	301-322-2127
Fax Number	:	301-322-9770

Provider Business Practice Location Address
First Line	:	6005 LANDOVER ROAD, SUITE 5
Second Line	:
City	:	CHEVERLY
State	:	MD
Zip	:	20785
Country	:	US
Telephone Number	:	301-322-2127
Fax Number	:	301-322-9770

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

Provider Enumeration Date	:	06/21/2012
Last Update Date	:	06/21/2012

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