Organization
CREATIVE LIFESTYLES MANAGEMENT PROG
Active
Other names
Laboratory For Sleep Disorders
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES R. STEWART (CFO)
(301) 877-4541
Entity
Organization
Contact information
Practice address
10 ST. PATRICKS DRIVE, SUITE 101, WALDORF, MD 20603-3500
(301) 877-4600
(301) 870-5747
Mailing address
7503 SURRATTS ROAD, CLINTON, MD 20735-3358
(301) 870-7001
(301) 870-6697
Taxonomy
Speciality
Code
Description
License number
State
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
11/08/2007
Last updated
11/10/2011
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