Provider Demographics
NPI:1104280114
Name:CHARLES-MARCEL, ZENO LANCELOT (MD)
Entity type:Individual
Prefix:
First Name:ZENO
Middle Name:LANCELOT
Last Name:CHARLES-MARCEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12501 OLD COLUMBIA PIKE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-6601
Mailing Address - Country:US
Mailing Address - Phone:301-680-6000
Mailing Address - Fax:301-680-6707
Practice Address - Street 1:12501 OLD COLUMBIA PIKE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-6601
Practice Address - Country:US
Practice Address - Phone:301-680-6000
Practice Address - Fax:301-680-6707
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-06
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK19989207QG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine