Healthcare Provider Details

I. General information

NPI: 1336675248
Provider Name (Legal Business Name): CARRIE GOLITKO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 05/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7401 GREENBELT RD PM PEDIATRICS
GREENBELT MD
20770-3402
US

IV. Provider business mailing address

7401 GREENBELT RD PM PEDIATRICS
GREENBELT MD
20770-3402
US

V. Phone/Fax

Practice location:
  • Phone: 301-982-5437
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0083375
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: