Provider Demographics
NPI:1164578118
Name:DEAN, CHARLOTTE KRATT (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLOTTE
Middle Name:KRATT
Last Name:DEAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CHARLOTTE
Other - Middle Name:ANTOINETTE
Other - Last Name:KRATT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2101 E JEFFERSON ST
Mailing Address - Street 2:KAISER PERMANENTE, PPQA, 6 WEST, ATTN: THERESA BROOKS
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4908
Mailing Address - Country:US
Mailing Address - Phone:301-816-6660
Mailing Address - Fax:301-816-6308
Practice Address - Street 1:110 IRVING ST NW, GB10
Practice Address - Street 2:KAISER PERMANENTE GB10
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2976
Practice Address - Country:US
Practice Address - Phone:202-877-7545
Practice Address - Fax:202-877-2550
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0047654207R00000X
DCMD31236207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G26545Medicare UPIN
005996M92Medicare ID - Type Unspecified