Healthcare Provider Details

I. General information

NPI: 1154462810
Provider Name (Legal Business Name): LAUREL PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

651 MAIN ST
LAUREL MD
20707-4067
US

IV. Provider business mailing address

4116 HOWARD RD
BELTSVILLE MD
20705-2800
US

V. Phone/Fax

Practice location:
  • Phone: 301-776-9191
  • Fax: 301-776-5757
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberH0062765
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License NumberD0044724
License Number StateMD

VIII. Authorized Official

Name: HELMY QURTOM
Title or Position: PRACTICE OWNER
Credential: M.D.
Phone: 301-776-9191