Organization
PRINCE GEORGE'S COUNTY HEALTH DEPARTMENT
Active
Other names
Colorectal Cancer
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DARLENE WHITAKER (MANAGER REVENUE)
(301) 883-7861
Entity
Organization
Contact information
Practice address
1801 MCCORMICK DR, SUITE 260, LARGO, MD 20774-5326
(301) 883-3524
Mailing address
1701 MCCORMICK DR, LARGO, MD 20774-5329
(301) 883-7861
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
74003
COLORECTAL CANCER
MD
Enumeration date
06/11/2007
Last updated
08/22/2020
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