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NPI Code Detail

MEDICARE: CPT, LLC

MEDICARE: CPT, LLC
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
1208D00000XGeneral Practice Physician

General Provider Information

NPI Number : 1609315126
Entity Type Code : Organization
Provider Name (Legal Business Name) : CPT, LLC
Provider Business Mailing Address
First Line : 249 HENDERSON AVE
Second Line :
City : CUMBERLAND
State : MD
Zip : 21502-1638
Country : US
Telephone Number : 240-362-7444
Fax Number : 240-362-7388
Provider Business Practice Location Address
First Line : 249 HENDERSON AVE
Second Line :
City : CUMBERLAND
State : MD
Zip : 21502-1638
Country : US
Telephone Number : 240-362-7444
Fax Number : 240-362-7388
Authorized Official
Title or Position : CREDENTIALING MANAGER
Name : TIFFANY KENNELL
Credential :
Telephone Number : 301-722-0616
Provider Enumeration Date : 02/16/2017
Last Update Date : 02/16/2017

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Directions to “CPT, LLC ” Practice Location

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