Center for Healthy Living of Maryland

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

D0035602 Issued in MD

Legal business name

CENTER FOR HEALTHY LIVING OF MARYLAND

Practice address

9662 Pennsylvania Ave
Upper Marlboro, MD 20772-3670

Phone

(301) 856-3004

Fax

(240) 269-0081

NPI assigned

Mar 12, 2010

Organization subpart

No

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

Authorized official

Name

Lloyd M Charles Jr., M.D.

Title

President

Phone

(301) 856-3004

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1268352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268352000000",
    "number": "1336462787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9662 PENNSYLVANIA AVE",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207723670",
            "telephone_number": "301-856-3004",
            "fax_number": "240-269-0081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9662 PENNSYLVANIA AVE",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207723670",
            "telephone_number": "301-856-3004",
            "fax_number": "240-269-0081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR HEALTHY LIVING OF MARYLAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-12",
        "last_updated": "2010-03-12",
        "status": "A",
        "authorized_official_last_name": "CHARLES",
        "authorized_official_first_name": "LLOYD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-856-3004",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MD",
            "license": "D0035602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cazobi Medical LLC
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• CCDC Professionals, LLC
• CCDC Professionals, LLC
• Ceff Family Health& Psychological Support LLC
• Center Pointe Counseling Services, LLC
• Aliyah Chamble
• Yolanda V Champion
• Jaylyn Chandler
• Jazzmine Chandler

• Pediatric Adolescent Medicine Physician in Upper Marlboro, MD
• Providers in Upper Marlboro, MD by specialty
• Pediatric Adolescent Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2010; 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.