Provider Demographics
NPI:1275834202
Name:VALERIE CALLENDER M. D. PC
Entity Type:Organization
Organization Name:VALERIE CALLENDER M. D. PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:CALLENDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-249-0970
Mailing Address - Street 1:12200 ANNAPOLIS RD
Mailing Address - Street 2:#315
Mailing Address - City:GLENN DALE
Mailing Address - State:MD
Mailing Address - Zip Code:20769-9182
Mailing Address - Country:US
Mailing Address - Phone:301-249-0970
Mailing Address - Fax:301-249-4246
Practice Address - Street 1:12200 ANNAPOLIS RD
Practice Address - Street 2:#315
Practice Address - City:GLENN DALE
Practice Address - State:MD
Practice Address - Zip Code:20769-9182
Practice Address - Country:US
Practice Address - Phone:301-249-0970
Practice Address - Fax:301-249-4246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-08
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0035709174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDA6270001OtherBLUE CROSS CLUE SHIELD DC
MDCCC1OtherBLUE CROSS BLUE SHIELD MD
MDCCC1OtherBLUE CROSS BLUE SHIELD MD
MD601605Medicare PIN
MDE41502Medicare UPIN