| Charles County Neurology | |
|
11637 Terrace Drive Suite 100 Waldorf MD 20602-3707 | |
| (301) 870-7287 | |
| (301) 870-0687 |
| Full Name | Charles County Neurology |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 11637 Terrace Drive, Waldorf, Maryland |
| Authorized Official Name and Position | Michael K Greenberg (MD) |
| Authorized Official Contact | 3018707287 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Charles County Neurology 11637 Terrace Drive Suite 100 Waldorf MD 20602-3707 Ph: (301) 870-7287 | Charles County Neurology 11637 Terrace Drive Suite 100 Waldorf MD 20602-3707 Ph: (301) 870-7287 |
| NPI Number | 1881718344 |
|---|---|
| Provider Enumeration Date | 03/19/2007 |
| Last Update Date | 10/22/2018 |
| Medicare PECOS PAC ID | 9335045996 |
|---|---|
| Medicare Enrollment ID | O20031212000373 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881718344 | NPI | - | NPPES |
| 743302600 | Medicaid | MD | |
| 1932192150 | Other | MD | NPI DR. GREENBERG |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | D48136 (Maryland) | Primary |
| Provider Name | Michael K Greenberg |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1932192150 PECOS PAC ID: 4183536311 Enrollment ID: I20031105000174 |
| Provider Name | Roche M Watson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639522659 PECOS PAC ID: 8628352283 Enrollment ID: I20170227000204 |
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