Provider Demographics
NPI:1780366526
Name:DOZIER, CHARLES ANTHONY (CERTIFIED MA)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:ANTHONY
Last Name:DOZIER
Suffix:
Gender:M
Credentials:CERTIFIED MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 GOOD HOPE RD SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-6912
Mailing Address - Country:US
Mailing Address - Phone:202-610-1886
Mailing Address - Fax:
Practice Address - Street 1:1320 GOOD HOPE RD SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-6912
Practice Address - Country:US
Practice Address - Phone:202-610-1886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCR8L7W9J4156F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156F00000XEye and Vision Services ProvidersTechnician/TechnologistGroup - Single Specialty