Provider Demographics
NPI:1881484343
Name:CARVAJAL, CESAR B
Entity type:Individual
Prefix:
First Name:CESAR
Middle Name:B
Last Name:CARVAJAL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 LEWIS AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20851-1624
Mailing Address - Country:US
Mailing Address - Phone:240-408-6984
Mailing Address - Fax:
Practice Address - Street 1:525 EASTERN AVE
Practice Address - Street 2:
Practice Address - City:FAIRMOUNT HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20743-1677
Practice Address - Country:US
Practice Address - Phone:301-925-2013
Practice Address - Fax:301-925-4367
Is Sole Proprietor?:No
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS04247111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor