Healthcare Provider Details

I. General information

NPI: 1174954705
Provider Name (Legal Business Name): ADVANCED NEIGHBORHOOD PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2013
Last Update Date: 12/02/2024
Certification Date: 12/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8607 2ND AVE STE 505A
SILVER SPRING MD
20910-3355
US

IV. Provider business mailing address

12239 CYPRESS SPRING RD SUITE 010
CLARKSBURG MD
20871-4415
US

V. Phone/Fax

Practice location:
  • Phone: 240-641-8160
  • Fax: 240-331-0073
Mailing address:
  • Phone: 240-374-8616
  • Fax: 240-780-7159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberD0063251
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberMD33750
License Number StateDC
# 4
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberD0063251
License Number StateMD
# 5
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberMD33750
License Number StateDC

VIII. Authorized Official

Name: DR. ONYINYE C ONYEKWERE
Title or Position: MEDICAL DIRECTOR
Credential: MD, MS, FAAP
Phone: 240-641-8160