MEDICARE: DR. J. PATRICK CAULFIELD M.D.

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	174400000X	Specialist	D13699	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1319437	OTHER	MD	ASBURY PHYSICIAN SERVICES
2	41178702	OTHER	MD	ASBURY PHYSICIAN SERVICES
3	52970024	OTHER	MH	ASBURY PHYSICIAN SERVICES

General Provider Information

NPI Number	:	1649275975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. J. PATRICK CAULFIELD M.D.

Provider Business Mailing Address
First Line	:	10215 FERNWOOD RD
Second Line	:	STE 506
City	:	BETHESDA
State	:	MD
Zip	:	20817-1184
Country	:	US
Telephone Number	:	301-530-1010
Fax Number	:	301-897-8597

Provider Business Practice Location Address
First Line	:	10215 FERNWOOD RD
Second Line	:	STE 506
City	:	BETHESDA
State	:	MD
Zip	:	20817-1184
Country	:	US
Telephone Number	:	301-530-1010
Fax Number	:	301-897-8597

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	07/08/2007

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