Healthcare Provider Details

I. General information

NPI: 1093976813
Provider Name (Legal Business Name): PEDIATRIC PROFESSIONALS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2008
Last Update Date: 03/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 IRVING ST NW STE 212
WASHINGTON DC
20010-2927
US

IV. Provider business mailing address

106 IRVING ST NW STE 212
WASHINGTON DC
20010-2927
US

V. Phone/Fax

Practice location:
  • Phone: 202-726-5800
  • Fax: 202-829-3753
Mailing address:
  • Phone: 202-726-5800
  • Fax: 202-829-3753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD035063
License Number StateDC

VIII. Authorized Official

Name: MR. YARED BELAI
Title or Position: BUSINESS MANAGER/SECRETARY
Credential: MBA
Phone: 301-529-8832