Healthcare Provider Details

I. General information

NPI: 1194585356
Provider Name (Legal Business Name): PEDIATRIC HEALTH CENTERS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2024
Last Update Date: 03/22/2024
Certification Date: 03/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 LANDOVER RD STE 5
CHEVERLY MD
20785-1143
US

IV. Provider business mailing address

6001 LANDOVER RD STE 5
CHEVERLY MD
20785-1143
US

V. Phone/Fax

Practice location:
  • Phone: 301-772-1212
  • Fax: 301-772-0033
Mailing address:
  • Phone: 301-772-1212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RITA ONYEWUENYI
Title or Position: PRESIDENT
Credential: MD
Phone: 301-772-1212