Provider Demographics
NPI:1578523130
Name:TUEGEL, CHARLES (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:
Last Name:TUEGEL
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 1:18111 PRINCE PHILIP DR
Mailing Address - Street 2:STE 323
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-1513
Mailing Address - Country:US
Mailing Address - Phone:301-774-2600
Mailing Address - Fax:301-771-2823
Practice Address - Street 1:18111 PRINCE PHILIP DR
Practice Address - Street 2:STE 323
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-1513
Practice Address - Country:US
Practice Address - Phone:301-774-2600
Practice Address - Fax:301-771-2823
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0019290207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC01190003OtherBC/DC/METRO
MD250251800Medicaid
MD831398OtherUNITED HEALTHCARE
MD42204701OtherBCBS OF MD
DC01190003OtherBC/DC/METRO
MD172567F20Medicare PIN