Organization
CHILDREN'S MEDICAL GROUP, P.A.
Active
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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