Individual
GERARD CHAMPALOUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
14300 GALLANT FOX LANE, SUITE 110, BOWIE, MD 20715-4031
(301) 262-6797
(301) 262-2564
Mailing address
14300 GALLANT FOX LANE, SUITE 110, BOWIE, MD 20715-4031
(301) 262-6797
(301) 262-2564
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0020905
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
784741600
—
MD
Enumeration date
09/01/2006
Last updated
12/02/2019
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