Organization
PRINCE GEORGE'S COUNTY HEALTH DEPARTMENT
Active
Parent organization
PRINCE GEORGE'S COUNTY HEALTH DEPARTMENT
Other names
Prince George's County Health Department-SBW-Bladensburg
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRINCE GEORGE'S COUNTY HEALTH DEPARTMENT
Authorized official
TAMALA BUTLER (CREDENTIALING SPECIALIST)
(301) 883-7822
Entity
Organization
Contact information
Practice address
4200 57TH AVE, BLADENSBURG, MD 20710-1710
(240) 696-3356
(301) 883-7890
Mailing address
1701 MCCORMICK DR STE 120, LARGO, MD 20774-5329
(301) 883-7822
(301) 883-7890
Taxonomy
Speciality
Code
Description
License number
State
207QA0000X
Adolescent Medicine (Family Medicine) Physician
—
—
261QS1000X
Student Health Clinic/Center
Primary
—
—
Other
Enumeration date
04/30/2018
Last updated
09/17/2020
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