Organization
CHILDREN'S MEDICAL GROUP, P.A.
Active
Parent organization
CHILDREN'S MEDICAL GROUP, P.A.
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHILDREN'S MEDICAL GROUP, P.A.
Authorized official
CHERIE L WILSON (OFFICE MANAGER)
(301) 724-7616
Entity
Organization
Contact information
Practice address
500 GREENE ST, CUMBERLAND, MD 21502-2799
(301) 724-7616
(301) 724-4811
Mailing address
500 GREENE ST, CUMBERLAND, MD 21502-2755
(301) 724-7616
(301) 724-4811
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
910551400
—
MD
Enumeration date
09/04/2020
Last updated
09/04/2020
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