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Organization

PRINCE GEORGE'S COUNTY HEALTH DEPARTMENT

Active
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Organization

PRINCE GEORGE'S COUNTY HEALTH DEPARTMENT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DARLENE WHITAKER (REVENUE MANAGER)
(301) 883-7861
Entity
Organization

Contact information

Practice address
1701 MCCORMICK DR, LARGO, MD 20774-5329
(301) 883-7861
(301) 883-7890
Mailing address
1701 MCCORMICK DR, LARGO, MD 20774-5329

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
103T00000X
Psychologist
1223D0001X
Public Health Dentistry
163W00000X
Registered Nurse
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1083945125
MD
05
1114155694
MD
05
1205195013
MD
05
1366711947
MD
05
1578821153
MD
05
1609938992
MD
05
1871632539
MD
05
1932254299
MD
Enumeration date
03/06/2013
Last updated
03/06/2013
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