| Organization Name: | PRINCE GEORGE HOSPITAL CENTER |
| NPI Number: | 1194976035 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHRISTEN LEDDER (PHYSICIAN ASSISTANT) |
| Mailing Address: | 3001 Hospital Dr Cheverly |
| State: | MD US |
| Postal Code: | 207851189 |
| Phone Number: | 3016182000 |
| Fax Number: | |
| NPI Enumeration Date: | 10/09/2008 |
| NPI Last Update Date: | 10/09/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 282NC0060X |
| License Number: | C003872 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Hospitals |
| Taxonomy Classification: | General Acute Care Hospital |
| Taxonomy Specialization: | Critical Access |
| Taxonomy Definition: | |