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NPI Code Detail

MEDICARE: CHARLES COUNTY DEPARTMENT OF HEALTH

MEDICARE: CHARLES COUNTY DEPARTMENT OF HEALTH
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
1207Q00000XFamily Medicine Physician
2208D00000XGeneral Practice Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1659702215
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHARLES COUNTY DEPARTMENT OF HEALTH
Provider Business Mailing Address
First Line : PO BOX 1050
Second Line :
City : WHITE PLAINS
State : MD
Zip : 20695-1050
Country : US
Telephone Number : 301-609-6906
Fax Number :
Provider Business Practice Location Address
First Line : 4375 PORT TOBACCO RD
Second Line :
City : NANJEMOY
State : MD
Zip : 20662-3345
Country : US
Telephone Number : 301-609-6906
Fax Number :
Authorized Official
Title or Position : DIRECTOR OF ADMINSTRATION
Name : KAREN L MURPHY
Credential :
Telephone Number : 301-609-6906
Provider Enumeration Date : 12/09/2013
Last Update Date : 07/22/2014

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Directions to “CHARLES COUNTY DEPARTMENT OF HEALTH ” Practice Location

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