Organization
PRINCE GEORGES OBGYN ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD E. BLAKE MD (PRESIDENT)
(301) 983-9366
Entity
Organization
Contact information
Practice address
4333 OLD BRANCH AVE, SUITE PG1, TEMPLE HILLS, MD 20748-1848
(301) 983-9366
(301) 983-3283
Mailing address
8214 TUCKERMAN LN, POTOMAC, MD 20854-3744
(301) 983-9366
(301) 983-3283
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
D0030235
MD
Other
Enumeration date
09/09/2011
Last updated
09/09/2011
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