Healthcare Provider Details

I. General information

NPI: 1740277458
Provider Name (Legal Business Name): CYNTHIA HEATHER CAMPBELL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CYNTHIA CAMPBELL HAITH M.D.

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4357 NORTHVIEW DR
BOWIE MD
20716-2603
US

IV. Provider business mailing address

4357 NORTHVIEW DR
BOWIE MD
20716-2603
US

V. Phone/Fax

Practice location:
  • Phone: 301-352-6515
  • Fax: 301-352-6516
Mailing address:
  • Phone: 301-352-6515
  • Fax: 301-352-6516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0061957
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: