Healthcare Provider Details

I. General information

NPI: 1902998867
Provider Name (Legal Business Name): COMMUNITY HEMATOLOGY ONCOLOGY PRACTITIONERS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 10/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18111 PRINCE PHILIP DRIVE SUITE 327
OLNEY MD
20832
US

IV. Provider business mailing address

18111 PRINCE PHILIP DRIVE SUITE 327
OLNEY MD
20832
US

V. Phone/Fax

Practice location:
  • Phone: 301-774-6136
  • Fax: 301-570-0136
Mailing address:
  • Phone: 301-774-6136
  • Fax: 301-570-0136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: CHITRA RAJAGOPAL
Title or Position: VICE PRESIDENT CORPORATION
Credential: MD
Phone: 301-774-6136