Healthcare Provider Details

I. General information

NPI: 1639227077
Provider Name (Legal Business Name): MONIQUE SYLVIA PARR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14924 JOSHUA TREE RD
NORTH POTOMAC MD
20878-2564
US

IV. Provider business mailing address

14924 JOSHUA TREE RD
NORTH POTOMAC MD
20878-2564
US

V. Phone/Fax

Practice location:
  • Phone: 301-340-7763
  • Fax: 301-340-7763
Mailing address:
  • Phone: 301-340-7763
  • Fax: 301-340-7763

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0042438
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: