Provider Demographics
NPI:1922787472
Name:CARTLEDGE, JUAN CHAVALIER II
Entity Type:Individual
Prefix:
First Name:JUAN
Middle Name:CHAVALIER
Last Name:CARTLEDGE
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 60TH AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRMOUNT HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20743-1420
Mailing Address - Country:US
Mailing Address - Phone:202-560-2976
Mailing Address - Fax:
Practice Address - Street 1:1818 NEW YORK AVE NE STE 115
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-1851
Practice Address - Country:US
Practice Address - Phone:202-269-2401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator