1033258884 NPI number — MR. CHARLES CURRAN P.T.

Table of content: MR. CHARLES CURRAN P.T. (NPI 1033258884)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033258884 NPI number — MR. CHARLES CURRAN P.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CURRAN
Provider First Name:
CHARLES
Provider Middle Name:
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
P.T.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033258884
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/30/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11070 CATHELL RD STE 4
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BERLIN
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21811-9344
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-208-3630
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11070 CATHELL RD
Provider Second Line Business Practice Location Address:
SUITE 4
Provider Business Practice Location Address City Name:
BERLIN
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21811-9344
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-208-3630
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  18278 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 713M . This is a "MEDICARE GROUP #" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 713MR273 . This is a "MEDICARE INDIVIDUAL #" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: G02084 . This is a "MEDICARE GROUP #" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 9000709DE . This is a "BLUE CROSS GROUP #" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 022657A84 . This is a "MEDICARE INDIVIDUAL #" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 84128704 . This is a "CAREFIRST INDIVI REND. #" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: J5640007 . This is a "BLUE CHOICE INDIVID. #" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 1124117916 . This is a "GROUP NPI #" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 754AAT . This is a "CAREFIRST GROUP #" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: J564 . This is a "BLUE CHOICE GROUP #" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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