Healthcare Provider Details

I. General information

NPI: 1750322483
Provider Name (Legal Business Name): CHARLES LIVINGSTON PARMELE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 FORBES ST STE 200
ANNAPOLIS MD
21401-1538
US

IV. Provider business mailing address

200 FORBES ST STE 200
ANNAPOLIS MD
21401-1538
US

V. Phone/Fax

Practice location:
  • Phone: 410-263-6363
  • Fax: 410-263-4086
Mailing address:
  • Phone: 410-263-6363
  • Fax: 410-263-4086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License NumberD0057434
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: