Provider Demographics
NPI:1740263425
Name:BOICE, CHARLES R (MD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:R
Last Name:BOICE
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 1:10301 GEORGIA AVE
Mailing Address - Street 2:STE 205
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-5020
Mailing Address - Country:US
Mailing Address - Phone:301-592-1600
Mailing Address - Fax:301-592-1602
Practice Address - Street 1:10301 GEORGIA AVE
Practice Address - Street 2:STE 205
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-5020
Practice Address - Country:US
Practice Address - Phone:301-592-1600
Practice Address - Fax:301-592-1602
Is Sole Proprietor?:No
Enumeration Date:2005-11-27
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0029142207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDA43300Medicare UPIN
MD005615C21Medicare ID - Type Unspecified
MD32100400Medicare ID - Type Unspecified