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NPI Code Detail

MEDICARE: DR. CHARLES BESONG RN, DNP, MSN, FNP-BC

MEDICARE: DR. CHARLES BESONG RN, DNP, MSN, FNP-BC
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
1363LF0000XFamily Nurse PractitionerR199032MD
2363LF0000XFamily Nurse PractitionerRN1025737DC

General Provider Information

NPI Number : 1720432172
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHARLES BESONG RN, DNP, MSN, FNP-BC
Provider Business Mailing Address
First Line : 3323 BEAVERWOOD LN
Second Line :
City : SILVER SPRING
State : MD
Zip : 20906-3064
Country : US
Telephone Number : 240-491-2868
Fax Number :
Provider Business Practice Location Address
First Line : 3341 BENNING RD NE
Second Line :
City : WASHINGTON
State : DC
Zip : 20019-1502
Country : US
Telephone Number : 202-543-0387
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2016
Last Update Date : 06/08/2016

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