# PRINCE GEORGES OBGYN ASSOCIATES PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528340197
- **Authorized official:** DR. RICHARD E. BLAKE MD (PRESIDENT)
- **Authorized official phone:** (301) 983-9366

## Contact information

- **Practice address:** 4333 OLD BRANCH AVE, SUITE PG1, TEMPLE HILLS, MD 20748-1848
- **Practice address phone:** (301) 983-9366
- **Practice address fax:** (301) 983-3283
- **Mailing address:** 8214 TUCKERMAN LN, POTOMAC, MD 20854-3744
- **Mailing address phone:** (301) 983-9366
- **Mailing address fax:** (301) 983-3283

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | D0030235 | MD | Yes |

## Other

- **Enumeration date:** 09/09/2011
- **Last updated:** 09/09/2011