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Organization
PRINCE GEORGES OBGYN ASSOCIATES PA
Active
Organization
PRINCE GEORGES OBGYN ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD E. BLAKE MD (PRESIDENT)
(301) 983-9366
Entity
Organization
Contact information
Practice address
4333 OLD BRANCH AVE, SUITE PG1, TEMPLE HILLS, MD 20748-1848
(301) 983-9366
(301) 983-3283
Mailing address
8214 TUCKERMAN LN, POTOMAC, MD 20854-3744
(301) 983-9366
(301) 983-3283
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
D0030235
MD
Other
Enumeration date
09/09/2011
Last updated
09/09/2011
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