Healthcare Provider Details

I. General information

NPI: 1730226267
Provider Name (Legal Business Name): CYNTHIA C CUDJOE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1140 N CAPITOL ST NW SUITE #924
WASHINGTON DC
20002-7583
US

IV. Provider business mailing address

8830 ALLISTON HOLLOW WAY
GAITHERSBURG MD
20879-1659
US

V. Phone/Fax

Practice location:
  • Phone: 202-589-1505
  • Fax: 202-589-1534
Mailing address:
  • Phone: 240-401-0224
  • Fax: 301-760-7281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License NumberMD32880
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: