Basic Information
| Provider Information | |||||||||
| NPI: | 1033258884 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CURRAN | ||||||||
| FirstName: | CHARLES | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11070 CATHELL RD STE 4 | ||||||||
| Address2: | |||||||||
| City: | BERLIN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 218119344 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4102083630 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 11070 CATHELL RD | ||||||||
| Address2: | SUITE 4 | ||||||||
| City: | BERLIN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 218119344 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4102083630 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/06/2007 | ||||||||
| LastUpdateDate: | 04/30/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 18278 | MD | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 713M | 01 | MD | MEDICARE GROUP # | OTHER | 713MR273 | 01 | MD | MEDICARE INDIVIDUAL # | OTHER | G02084 | 01 | DE | MEDICARE GROUP # | OTHER | 9000709DE | 01 | DE | BLUE CROSS GROUP # | OTHER | 022657A84 | 01 | DE | MEDICARE INDIVIDUAL # | OTHER | 84128704 | 01 | MD | CAREFIRST INDIVI REND. # | OTHER | J5640007 | 01 | MD | BLUE CHOICE INDIVID. # | OTHER | 1124117916 | 01 | MD | GROUP NPI # | OTHER | 754AAT | 01 | MD | CAREFIRST GROUP # | OTHER | J564 | 01 | MD | BLUE CHOICE GROUP # | OTHER |