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Individual

DR. CHARLES VINCENT JUDGE III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DOCTOR OF CHIROPRACT

Contact information

Practice address
3 POST OFFICE RD, SUITE 104, WALDORF, MD 20602
(301) 645-5393
(301) 645-9490
Mailing address
3 POST OFFICE RD, SUITE 104, WALDORF, MD 20602-2756
(301) 645-5393
(301) 645-9490

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
01688
MD
225100000X
Physical Therapist
01688
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
M199
BCBS OF MD
MD
01
T1630001
BCBS OF DC
MD
Enumeration date
11/30/2006
Last updated
06/14/2018
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