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General NPI Number Information
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NPI Number | 1225134331
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Entity Type | Individual
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Provider Name | CHARLES EDWARD MCQUEEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6900 GEORGIA AVE NW BORDEN PAVILLION WALTER REED ARMY MEDICAL CENTER
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City | WASHINGTON
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State | DC
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Zip | 20307-0001
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Country | US
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Telephone | 202-782-6389
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Fax |
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Provider Business Mailing Address
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Address Line | 16805 ETHELWOOD TER
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City | OLNEY
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State | MD
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Zip | 20832-2913
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Country | US
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Telephone | 301-774-1683
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | R6D70
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License Number State | MO
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