Provider Demographics
NPI:1770321549
Name:MUSE, CHARLES
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:
Last Name:MUSE
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 1:3421 RANDALL RD
Mailing Address - Street 2:
Mailing Address - City:SUITLAND
Mailing Address - State:MD
Mailing Address - Zip Code:20746-2148
Mailing Address - Country:US
Mailing Address - Phone:202-695-5024
Mailing Address - Fax:
Practice Address - Street 1:3421 RANDALL RD
Practice Address - Street 2:
Practice Address - City:SUITLAND
Practice Address - State:MD
Practice Address - Zip Code:20746-2148
Practice Address - Country:US
Practice Address - Phone:202-695-5024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant