Family Medicine
PHS FAMILY MEDICINE GLENN DALE
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1962842401 · enumerated 2013-06-28 · record updated 2016-09-06. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Authorized official: Mr. CHARLES HABERKERN, VP · (202) 854-4255
Other names: PROVIDENCE HEALTH SERVICES, INC
Addresses and phones
- Mailing address 1160 VARNUM ST NE, ST CATHERINE'S HALL, ROOM 102, WASHINGTON, DC, 20017-2107 (202) 854-4069 Fax (202) 854-7825 Google Maps Apple Maps OpenStreetMap
- Practice location 12200 ANNAPOLIS RD, SUITE 118, GLENN DALE, MD, 20769-9182 (301) 464-9300 Fax (202) 854-4093 Google Maps Apple Maps OpenStreetMap
Specialties
- General Acute Care Hospital 282N00000X · License HFD01-0212 DC
- Family Medicine 207Q00000X · Primary · License HFD01-0212 DC
In this directory
Locations and evidence
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Practice location
GLENN DALE, MD, 207699182
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.