Provider Demographics
NPI:1508846817
Name:TONER, CHARLES BRADIE (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:BRADIE
Last Name:TONER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6410 ROCKLEDGE DR
Mailing Address - Street 2:STE 300
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-7811
Mailing Address - Country:US
Mailing Address - Phone:240-515-6674
Mailing Address - Fax:
Practice Address - Street 1:9131 PISCATAWAY RD STE 550
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735
Practice Address - Country:US
Practice Address - Phone:301-966-7744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA057505174400000X, 207N00000X, 207ND0101X, 207ND0900X, 207NP0225X, 207NS0135X, 207ZD0900X, 208D00000X
VA0101054810207ND0101X
MDD0067264207ND0101X
MDD67264207ND0101X, 207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No174400000XOther Service ProvidersSpecialist
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
No207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
No207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
GUG14994Medicare UPIN