Conlon, Charles Joseph

Conlon, Charles Joseph is an individual health care provider with primary practice located at 1396 Piccard Dr Kaiser Permanente Shady Grove Medical Center, Rockville MD 20850-4302. He recently has only one registered license in Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics, which is considered as his primary health care specialty. Conlon, Charles Joseph can be contacted via phone (301) 548-5700.

Contact Information

Primary practice address
1396 Piccard Dr Kaiser Permanente Shady Grove Medical Center Rockville MD 20850-4302
Phone: (301) 548-5700
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics 2080P0006X MD15263 District of Columbia
Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics 2080P0006X D54729 Maryland

Profile Details

NPI number 1093896821
LBN Legal business name Conlon, Charles Joseph
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2006
Last updated Dec 6th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093896821 NPPES
Virginia MEDICAID 6730230
Virginia MEDICAID 028082100
Virginia MEDICAID 205000500

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