Provider Demographics
NPI:1336218122
Name:WINTERS, PATRICK CARL (DC)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:CARL
Last Name:WINTERS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6750 CRAIN HWY
Mailing Address - Street 2:PO BOX 1965
Mailing Address - City:LA PLATA
Mailing Address - State:MD
Mailing Address - Zip Code:20646-4961
Mailing Address - Country:US
Mailing Address - Phone:301-392-1082
Mailing Address - Fax:301-392-1084
Practice Address - Street 1:6750 CRAIN HWY
Practice Address - Street 2:
Practice Address - City:LA PLATA
Practice Address - State:MD
Practice Address - Zip Code:20646-4961
Practice Address - Country:US
Practice Address - Phone:301-392-1082
Practice Address - Fax:301-392-1084
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS01938111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDU70850Medicare UPIN