Buckley, Charles Edward

Buckley, Charles Edward is an individual health care provider with primary practice located at 4700 Berwyn House Rd Suite 102, College Park MD 20740-2474. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nuclear Radiology, which is considered as his primary health care specialty. Buckley, Charles Edward can be contacted via phone (301) 345-0406.

Contact Information

Primary practice address
4700 Berwyn House Rd Suite 102 College Park MD 20740-2474
Phone: (301) 345-0406
Fax: (301) 345-0409
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nuclear Radiology 2085N0904X D16341 Maryland
Allopathic & Osteopathic Physicians / Nuclear Radiology 2085N0904X MD25540 District of Columbia
Allopathic & Osteopathic Physicians / Nuclear Radiology 2085N0904X 019671 Virginia

Profile Details

NPI number 1134128051
LBN Legal business name Buckley, Charles Edward
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2005
Last updated Mar 14th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134128051 NPPES
District of Columbia MEDICAID 0430630

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