Creative Lifestyles Management Prog

Primary specialty

Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X

Legal business name

CREATIVE LIFESTYLES MANAGEMENT PROG

Doing business as

Laboratory For Sleep Disorders

Practice address

10 St. Patricks Drive
Suite 101
Waldorf, MD 20603-3500

Phone

(301) 877-4600

Fax

(301) 870-5747

NPI assigned

Nov 8, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Charles R. Stewart

Title

Cfo

Phone

(301) 877-4541

Specialties & licenses 1

Addresses

Other names 1

• Laboratory For Sleep Disorders Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bahram Redjaee, M.D.

  • Pulmonary Disease Physician
  • Temple Hills, MD
  • NPI 1073504700
  NPD (past)

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

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320883200000",
    "number": "1447430376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7503 SURRATTS ROAD",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207353358",
            "telephone_number": "301-870-7001",
            "fax_number": "301-870-6697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 ST. PATRICKS DRIVE",
            "address_2": "SUITE 101",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206033500",
            "telephone_number": "301-877-4600",
            "fax_number": "301-870-5747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE LIFESTYLES MANAGEMENT PROG",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-08",
        "last_updated": "2011-11-10",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "301-877-4541",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RS0012X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laboratory For Sleep Disorders",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Creigh Crandall, DDS
• Jackie Dutchess Crawford, MHSA
• Jan Crawford
• Jess Hunley Crawford III, D.C.
• Creative Hands Services & Staffing, Inc.
• Creative Options & Employment, Inc
• Creigh Crandall DDS Waldorf PC
• Randy Lee Crispin, PHARMACIST
• Ronald K Criss, DPM, PC
• Kierra Croons

• Sleep Medicine (Internal Medicine) Physician in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Sleep Medicine (Internal Medicine) Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2011; 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.