CREATIVE LIFESTYLES MANAGEMENT PROG NPI 1447430376

NPI Information

  • NPI: 1447430376
  • Provider Name: CREATIVE LIFESTYLES MANAGEMENT PROG
  • Classification: Internal Medicine - 207RS0012X
  • Specialization: Sleep Medicine
  • Entity Type: Organization
  • Doing Business As: LABORATORY FOR SLEEP DISORDERS
  • Address: 10 ST. PATRICKS DRIVE
    SUITE 101
    WALDORF, MD
    ZIP 20603
  • Phone: (301) 877-4600

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NPI Details

CREATIVE LIFESTYLES MANAGEMENT PROG is a sleep medicine internal medicine in Waldorf, MD. The provider is an Internist who practices Sleep Medicine is certified in the subspecialty of sleep medicine and specializes in the clinical assessment, physiologic testing, diagnosis, management and prevention of sleep and circadian rhythm disorders. Sleep specialists treat patients of any age and use multidisciplinary approaches. Disorders managed by sleep specialists include, but are not limited to, sleep related breathing disorders, insomnia, hypersomnias, circadian rhythm sleep disorders, parasomnias and sleep related movement disorders. CREATIVE LIFESTYLES MANAGEMENT PROG NPI is 1447430376. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Laboratory For Sleep Disorders.

The provider's business location address is:

10 ST. PATRICKS DRIVE
SUITE 101
WALDORF, MD
ZIP 20603-500
Phone: (301) 877-4600
Fax: (301) 870-5747

The provider's authorized official is Charles R. Stewart .
The authorized official title is Cfo and has the following contact phone number (301) 877-4541.

The enumeration date for this NPI number is 11/8/2007 and was last updated on 11/10/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RS0012XInternal MedicineSleep MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1020MMEDICARE PINMARYLAND

What is NPI?

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This page was last updated on: 3/30/2025

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