Healthcare Provider Details

I. General information

NPI: 1194099788
Provider Name (Legal Business Name): SPRING PEDIATRICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/29/2012
Last Update Date: 09/06/2025
Certification Date: 09/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10750 COLUMBIA PIKE STE 230
SILVER SPRING MD
20901-4454
US

IV. Provider business mailing address

10750 COLUMBIA PIKE STE 230
SILVER SPRING MD
20901-4454
US

V. Phone/Fax

Practice location:
  • Phone: 301-585-9600
  • Fax:
Mailing address:
  • Phone: 301-585-9600
  • Fax: 301-585-5888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0082579
License Number StateMD

VIII. Authorized Official

Name: DR. ANTONIO E. CORNIER
Title or Position: PRESIDENT
Credential: MD
Phone: 301-585-9600