Healthcare Provider Details

I. General information

NPI: 1578490256
Provider Name (Legal Business Name): CHILDREN'S PEDIATRICIANS & ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9692 PENNSYLVANIA AVE
UPPER MARLBORO MD
20772-3670
US

IV. Provider business mailing address

12211 PLUM ORCHARD DR STE 100
SILVER SPRING MD
20904-7903
US

V. Phone/Fax

Practice location:
  • Phone: 301-599-7300
  • Fax:
Mailing address:
  • Phone: 202-604-1836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROBERT JAMES GRADY SR.
Title or Position: DIRECTOR OF PFS
Credential:
Phone: 301-572-6284