Healthcare Provider Details

I. General information

NPI: 1386147932
Provider Name (Legal Business Name): DAS PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2018
Last Update Date: 03/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

821 N EUTAW ST STE 305
BALTIMORE MD
21201-6303
US

IV. Provider business mailing address

101 ROSELAWN CT
BEL AIR MD
21014-5675
US

V. Phone/Fax

Practice location:
  • Phone: 410-384-3625
  • Fax: 443-853-3766
Mailing address:
  • Phone: 410-384-3625
  • Fax: 443-853-3766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0032132
License Number StateMD

VIII. Authorized Official

Name: AJIT DAS
Title or Position: OWNER
Credential: M.D
Phone: 410-384-3625