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Ch MD Southern Collaborative Care PC

Internal Medicine in Waldorf, MD. Organization (NPI-2).

NPI number1982005237
StatusActive
Last updated in NPPESFeb 10, 2015

Details

NPI
1982005237
Entity type
Organization (NPI-2)
Legal business name
Ch MD Southern Collaborative Care PC
Organization subpart
No
Enumeration date
Sep 5, 2014
Last updated
Feb 10, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine––Yes

Practice location

2300 Oxford Shire Ct
Waldorf, MD 20603-3215

Phone 667-207-7006 · Fax 888-722-4282

Mailing address

4055 Valley View Ln
Suite 400
Dallas, TX 75244-5074

Phone 972-715-3800 · Fax 888-722-4282

Authorized official

Melissa M Cooke
Chief Financial Officer
9727153808

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