Healthcare Provider Details

I. General information

NPI: 1245179829
Provider Name (Legal Business Name): PEDIATRIC GREAT CARE, L.L.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2026
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 HARRY S TRUMAN DR N
LARGO MD
20774-5477
US

IV. Provider business mailing address

12530 FAIRWOOD PKWY STE 1021247
BOWIE MD
20720-6356
US

V. Phone/Fax

Practice location:
  • Phone: 240-677-1000
  • Fax:
Mailing address:
  • Phone: 848-391-7520
  • 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: TAREK AHMED AWAD BELAL
Title or Position: OWNER
Credential: MD
Phone: 848-391-7520