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General NPI Number Information
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NPI Number | 1881557056
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Entity Type | Individual
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Provider Name | CHARLES CLAYBORNE
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Gender | Male
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Dates
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Enumeration Date | 12/04/2025
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 1008 50TH PL NE
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City | WASHINGTON
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State | DC
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Zip | 20019-4008
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Country | US
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Telephone | 227-225-6807
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Fax |
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Provider Business Mailing Address
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Address Line | 3726 HAYES ST NE APT 2
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City | WASHINGTON
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State | DC
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Zip | 20019-1714
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Country | US
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Telephone | 540-277-4433
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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 | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number | 1333393
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License Number State | DC
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