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General NPI Number Information
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NPI Number | 1225196751
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Entity Type | Organization
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Legal Business Name | CHARLES J COURTNEY
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 07/24/2008
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Provider Practice Location Address
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Address Line | 8625 16TH ST
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City | SILVER SPRING
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State | MD
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Zip | 20910-2261
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Country | US
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Telephone | 301-587-6892
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Fax | 301-587-2750
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Provider Business Mailing Address
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Address Line | 8625 16TH ST
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City | SILVER SPRING
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State | MD
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Zip | 20910-2261
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Country | US
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Telephone | 301-587-6892
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Fax | 301-587-2750
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Authorized Official
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Title or Position | MGR.
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Name | MS. KATHRYN L COURTNEY
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Credential |
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Telephone | 301-587-6892
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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