NPIMap

Organization Active NPI

Charles County Dermatology Associates LLC

  • Dermatology Physician
  • White Plains, MD
National Provider Identifier
1952413080
Registry record updated Mar 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
CHARLES COUNTY DERMATOLOGY ASSOCIATES LLC
Practice address
4225 Altamont Place
Unit 3
White Plains, MD 20695
Phone
(301) 843-1600
Fax
(301) 645-4734
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2008

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

Authorized official

Name
Dr. Robert Berger, MD PA
Title
Doctor
Phone
(301) 843-1600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

4225 Altamont Place
Unit 3
White Plains, MD 20695

Mailing address

P.O Box 791011
Baltimore, MD 21279
Phone (301) 843-1600

Other identifiers 1

IdentifierTypeStateIssuer
415POtherMDMEDICARE GROUP

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205798400000",
    "number": "1952413080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O BOX 791011",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21279",
            "telephone_number": "301-843-1600",
            "fax_number": "301-645-4734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4225 ALTAMONT PLACE",
            "address_2": "UNIT 3",
            "city": "WHITE PLAINS",
            "state": "MD",
            "postal_code": "20695",
            "telephone_number": "301-843-1600",
            "fax_number": "301-645-4734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES COUNTY DERMATOLOGY ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-03-18",
        "status": "A",
        "authorized_official_last_name": "BERGER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "301-843-1600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD PA"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "415P",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.