# CH MD SOUTHERN COLLABORATIVE CARE PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1982005237
- **Authorized official:** MELISSA M COOKE (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (972) 715-3808

## Contact information

- **Practice address:** 2300 OXFORD SHIRE CT, WALDORF, MD 20603-3215
- **Practice address phone:** (667) 207-7006
- **Practice address fax:** (888) 722-4282
- **Mailing address:** 4055 VALLEY VIEW LN, SUITE 400, DALLAS, TX 75244-5074
- **Mailing address phone:** (972) 715-3800
- **Mailing address fax:** (888) 722-4282

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/05/2014
- **Last updated:** 02/10/2015