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Organization
CH MD SOUTHERN COLLABORATIVE CARE PC
Active
Organization
CH MD SOUTHERN COLLABORATIVE CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA M COOKE (CHIEF FINANCIAL OFFICER)
(972) 715-3808
Entity
Organization
Contact information
Practice address
2300 OXFORD SHIRE CT, WALDORF, MD 20603-3215
(667) 207-7006
(888) 722-4282
Mailing address
4055 VALLEY VIEW LN, SUITE 400, DALLAS, TX 75244-5074
(972) 715-3800
(888) 722-4282
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
09/05/2014
Last updated
02/10/2015
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