Healthcare Provider Details

I. General information

NPI: 1649812785
Provider Name (Legal Business Name): A PLUS PEDIATRICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2019
Last Update Date: 10/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

845 QUINCE ORCHARD BLVD STE B
GAITHERSBURG MD
20878-1676
US

IV. Provider business mailing address

15221 GRAVENSTEIN WAY
NORTH POTOMAC MD
20878-4701
US

V. Phone/Fax

Practice location:
  • Phone: 301-977-2440
  • Fax:
Mailing address:
  • Phone: 347-204-7496
  • 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: VAHID KHAJOEE
Title or Position: CEO
Credential: MD
Phone: 347-204-7496