Phs Family Medicine Glenn Dale
NPI 1962842401 · Family Medicine Physician · Glenn Dale, MD
Phs Family Medicine Glenn Dale is a Family Medicine Physician organization in Glenn Dale, MD (NPI 1962842401).
Provider details
- NPI number
- 1962842401
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Providence Hospital
- Organization subpart
- Yes
- Authorized official
- Charles Haberkern, Vp(202) 854-4255
- License
- HFD01-0212 (DC)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Hospitals
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Other name
- Providence Health Services, Inc
Registry dates
- Enumerated
- 2013-06-28
- Last updated
- 2016-09-06
Frequently asked questions
- What is Phs Family Medicine Glenn Dale's NPI number?
- Phs Family Medicine Glenn Dale's National Provider Identifier (NPI) is 1962842401, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Phs Family Medicine Glenn Dale?
- Phs Family Medicine Glenn Dale is classified in the NPPES registry as Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Phs Family Medicine Glenn Dale located?
- Phs Family Medicine Glenn Dale's practice location on file with NPPES is 12200 Annapolis Rd, Glenn Dale, MD 20769-9182.
- What is Phs Family Medicine Glenn Dale's phone number?
- The practice phone number listed in the NPPES registry for Phs Family Medicine Glenn Dale is (301) 464-9300.
- Who is the authorized official for Phs Family Medicine Glenn Dale?
- The authorized official listed on Phs Family Medicine Glenn Dale's NPPES record is Charles Haberkern, Vp. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Phs Family Medicine Glenn Dale's NPI active?
- Yes — Phs Family Medicine Glenn Dale's NPI (1962842401) is active in the NPPES registry as of the last update on 2016-09-06.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.