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General NPI Number Information
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NPI Number | 1962534206
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Entity Type | Individual
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Provider Name | CHARLES JEFFRY KESSLER MD
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Gender | Male
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 06/15/2012
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Provider Practice Location Address
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Address Line | 8945 N WESTLAND DR SUITE 100
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City | GAITHERSBURG
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State | MD
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Zip | 20877-1249
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Country | US
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Telephone | 301-869-1230
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Fax | 301-869-1390
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Provider Business Mailing Address
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Address Line | 8945 N WESTLAND DR SUITE 100
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City | GAITHERSBURG
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State | MD
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Zip | 20877-1249
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Country | US
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Telephone | 301-869-1230
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Fax | 301-869-1390
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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 | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number | 84348
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | D0073675
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License Number State | MD
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