Provider Demographics
NPI:1700650009
Name:CALDWELL, MARQUES DARNELL
Entity Type:Individual
Prefix:
First Name:MARQUES
Middle Name:DARNELL
Last Name:CALDWELL
Suffix:
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 1:2607 BOWEN RD SE APT 2
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-6618
Mailing Address - Country:US
Mailing Address - Phone:202-480-0331
Mailing Address - Fax:
Practice Address - Street 1:2607 BOWEN RD SE APT 2
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-6618
Practice Address - Country:US
Practice Address - Phone:202-480-0331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-08
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant