Provider Demographics
NPI:1568766988
Name:CURTIS, CHARLES WILBERT II (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:WILBERT
Last Name:CURTIS
Suffix:II
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60144
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20039-0144
Mailing Address - Country:US
Mailing Address - Phone:804-677-3270
Mailing Address - Fax:
Practice Address - Street 1:15000 BROSCHART RD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3303
Practice Address - Country:US
Practice Address - Phone:301-251-6854
Practice Address - Fax:301-251-6831
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-28
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04818103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent