Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 272572 | MA |
N | 111NI0900X | Internist | 272572 | MA |
Y | 208D00000X | General Practice Physician | D0086374 | MD |
NPI | 1043731946 |
---|---|
Provider Name | Dr. Craig Lamar Cheeks Washington |
First Address | Frederick, MD 21705-4221 |
Second Address | Cambridge, MA 02138-5502 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2017 |
Last Update Date | 03/12/2018 |