Provider Demographics
NPI:1558171850
Name:STOTTS, CHARLES V (CPR, FIRST AID, AED)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:V
Last Name:STOTTS
Suffix:
Gender:M
Credentials:CPR, FIRST AID, AED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1443 SMITH PL SE APT 102
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-4777
Mailing Address - Country:US
Mailing Address - Phone:202-883-0378
Mailing Address - Fax:
Practice Address - Street 1:701 BRANDYWINE ST SE APT 301
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-3551
Practice Address - Country:US
Practice Address - Phone:202-883-0378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-09
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC2560158192423747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant