Provider Demographics
NPI:1649275975
Name:CAULFIELD, J. PATRICK (MD)
Entity type:Individual
Prefix:DR
First Name:J. PATRICK
Middle Name:
Last Name:CAULFIELD
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 1:10215 FERNWOOD RD
Mailing Address - Street 2:STE 506
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1184
Mailing Address - Country:US
Mailing Address - Phone:301-530-1010
Mailing Address - Fax:301-897-8597
Practice Address - Street 1:10215 FERNWOOD RD
Practice Address - Street 2:STE 506
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1184
Practice Address - Country:US
Practice Address - Phone:301-530-1010
Practice Address - Fax:301-897-8597
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD13699174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1319437OtherASBURY PHYSICIAN SERVICES
MD41178702OtherASBURY PHYSICIAN SERVICES
MH52970024OtherASBURY PHYSICIAN SERVICES
MD1319437OtherASBURY PHYSICIAN SERVICES
MD41178702OtherASBURY PHYSICIAN SERVICES
MD018151A94Medicare ID - Type UnspecifiedASBURY PHYSICIAN SERVICES