Healthcare Provider Details

I. General information

NPI: 1013905546
Provider Name (Legal Business Name): APRIL D TWEEDT D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18111 PRINCE PHILIP DR T-12
OLNEY MD
20832-1513
US

IV. Provider business mailing address

18111 PRINCE PHILIP DR T-12
OLNEY MD
20832-1513
US

V. Phone/Fax

Practice location:
  • Phone: 301-570-7770
  • Fax: 301-774-7724
Mailing address:
  • Phone: 301-570-7770
  • Fax: 301-774-7724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0000X
TaxonomyAdolescent Medicine (Family Medicine) Physician
License NumberH0063234
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: