NPIMap

Organization Active NPI

Coryse Brathwaite-Dean, MD, PC

  • Medical Specialty Clinic/Center
  • Waldorf, MD
National Provider Identifier
1306099833
Registry record updated Oct 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
D46239 Issued in MD
Legal business name
CORYSE BRATHWAITE-DEAN, MD, PC
Practice address
3460 Old Washington Rd
Suite 101
Waldorf, MD 20602-3240
Phone
(301) 705-6500
Fax
(301) 705-5822
NPI assigned
Oct 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Coryse V Brathwaite, M.D.
Title
Owner
Phone
(301) 705-6500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X D46239 MD Primary

Addresses

Primary practice location

3460 Old Washington Rd
Suite 101
Waldorf, MD 20602-3240

Mailing address

PO Box 6438
Waldorf, MD 20603-6438
Phone (301) 705-6500

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225152000000",
    "number": "1306099833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6438",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206036438",
            "telephone_number": "301-705-6500",
            "fax_number": "301-705-5822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3460 OLD WASHINGTON RD",
            "address_2": "SUITE 101",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023240",
            "telephone_number": "301-705-6500",
            "fax_number": "301-705-5822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORYSE BRATHWAITE-DEAN, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-28",
        "last_updated": "2008-10-28",
        "status": "A",
        "authorized_official_last_name": "BRATHWAITE",
        "authorized_official_first_name": "CORYSE",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-705-6500",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "MD",
            "license": "D46239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.