MEDICARE: GERMANTOWN REPRODUCTIVE HEALTH SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	D0071127	MD

General Provider Information

NPI Number	:	1053686063
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GERMANTOWN REPRODUCTIVE HEALTH SERVICES, INC.

Provider Business Mailing Address
First Line	:	13233 EXECUTIVE PARK TER
Second Line	:
City	:	GERMANTOWN
State	:	MD
Zip	:	20874-2648
Country	:	US
Telephone Number	:	301-353-9200
Fax Number	:	301-601-4318

Provider Business Practice Location Address
First Line	:	13233 EXECUTIVE PARK TER
Second Line	:
City	:	GERMANTOWN
State	:	MD
Zip	:	20874-2648
Country	:	US
Telephone Number	:	301-353-9200
Fax Number	:	301-601-4318

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. LEROY HARRISON CARHART JR.
Credential	:	M.D.
Telephone Number	:	301-353-9200

Provider Enumeration Date	:	03/09/2012
Last Update Date	:	03/09/2012

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