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Contact Information

CCDC PROFESSIONALS, LLC
1220 CARAWAY CT STE 1050
UPPER MARLBORO, MD20774-5338
 Phone: 301-494-3000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
 

Dentist Anesthesiologist

1223D0004X
 

Nurse Anesthetist, Certified Registered

367500000X 43 Certified Registered Nurse Anesthetist (CRNA)
 

Pediatric Anesthesiology

207LP3000X 05 Physician/Anesthesiology
Indicates primary specialty

NPI Profile & details for CCDC PROFESSIONALS LLC · (Female)

NPI Number 1205542214
Status Active
Credentials
Entity Individual
Enumeration date 01/24/2023
Last updated 01/13/2026 - About 5 months ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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