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Individual
DR. CHARLES VINCENT JUDGE III
Active
Individual
DR. CHARLES VINCENT JUDGE III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DOCTOR OF CHIROPRACT
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
01688
MD
225100000X
Physical Therapist
01688
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M199
BCBS OF MD
MD
01
—
T1630001
BCBS OF DC
MD
Enumeration date
11/30/2006
Last updated
06/14/2018
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