Healthcare Provider Details

I. General information

NPI: 1578423265
Provider Name (Legal Business Name): WES PEDIATRICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2025
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1190 W NORTHERN PKWY STE 101
BALTIMORE MD
21210-1432
US

IV. Provider business mailing address

1190 W NORTHERN PKWY STE 101
BALTIMORE MD
21210-1432
US

V. Phone/Fax

Practice location:
  • Phone: 410-433-0801
  • Fax: 410-433-0803
Mailing address:
  • Phone: 410-433-0801
  • Fax: 410-433-0803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JESSICA SUZANNE DEUTSCH
Title or Position: OWNER
Credential: CPNP
Phone: 410-458-7541