Provider Demographics
NPI:1912948605
Name:CURTIS, CHARLES JR (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:
Last Name:CURTIS
Suffix:JR
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 1:612 HIDDEN POND LN
Mailing Address - Street 2:
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-2610
Mailing Address - Country:US
Mailing Address - Phone:410-384-7914
Mailing Address - Fax:
Practice Address - Street 1:900 CATON AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-5201
Practice Address - Country:US
Practice Address - Phone:410-368-7914
Practice Address - Fax:410-368-3575
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD51865207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD410700400Medicaid
MD60609101OtherBLUE CROSS
MDP00190075OtherRAILROAD MEDICARE
MD60609101OtherBLUE CROSS