Provider Demographics
NPI:1245311000
Name:GEORGE, CECIL DONALD (MD)
Entity type:Individual
Prefix:DR
First Name:CECIL
Middle Name:DONALD
Last Name:GEORGE
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 1:8116 GOOD LUCK RD
Mailing Address - Street 2:SUITE 305
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3502
Mailing Address - Country:US
Mailing Address - Phone:301-552-1200
Mailing Address - Fax:301-552-1202
Practice Address - Street 1:7500 GREENWAY CENTER DR STE 1200
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-3556
Practice Address - Country:US
Practice Address - Phone:301-486-7580
Practice Address - Fax:301-486-7581
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0058182207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD100921OtherJOHNS HOPKINS
491555Medicare ID - Type Unspecified
MD189416OtherAMERIGROUP
MDW741OtherCAREFIRST
MD401184800Medicaid
H80398Medicare UPIN