Provider Demographics
NPI:1912046129
Name:HESTER, CHARLES PAUL (DC)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:PAUL
Last Name:HESTER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22780 THREE NOTCH RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20653-1538
Mailing Address - Country:US
Mailing Address - Phone:301-737-0662
Mailing Address - Fax:301-737-0675
Practice Address - Street 1:22780 THREE NOTCH RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON PARK
Practice Address - State:MD
Practice Address - Zip Code:20653-1538
Practice Address - Country:US
Practice Address - Phone:301-737-0662
Practice Address - Fax:301-737-0675
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1343111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4411223002OtherCIGNA HMO
MD147743500OtherFEDERAL WORKERS COMP.
MDT2890002OtherBLUECROSS FEDERAL
MD4411223001OtherCIGNA PPO
MD2863609OtherAETNA
MD513654OtherALLIANCE
MDLK96GROtherBLUECROSS MARYLAND
MD2863609OtherAETNA
MD4411223002OtherCIGNA HMO