Individual
CHARLES EDWARD BUCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4700 BERWYN HOUSE RD, SUITE 102, COLLEGE PARK, MD 20740-2474
(301) 345-0406
(301) 345-0409
Mailing address
4700 BERWYN HOUSE RD, SUITE 207, COLLEGE PARK, MD 20740-2474
(301) 220-0150
(301) 220-1032
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
019671
VA
2085N0904X
Nuclear Radiology Physician
Primary
D16341
MD
2085N0904X
Nuclear Radiology Physician
MD25540
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0430630
—
DC
Enumeration date
07/21/2005
Last updated
03/14/2008
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