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General NPI Number Information
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NPI Number | 1669750303
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Entity Type | Organization
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Legal Business Name | NEXT GENERATION PEDIATRICS LLC
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Dates
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Enumeration Date | 07/29/2011
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Last Update Date | 07/29/2011
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Provider Practice Location Address
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Address Line | 4549 WINDSOR LN
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City | BETHESDA
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State | MD
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Zip | 20814-4724
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Country | US
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Telephone | 301-832-6048
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Fax |
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Provider Business Mailing Address
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Address Line | 5622 SHIELDS DR
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City | BETHESDA
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State | MD
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Zip | 20817-3532
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Country | US
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Telephone | 301-832-6048
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | LEILA T HALL
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Credential | MD
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Telephone | 301-832-6048
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | D0062614
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License Number State | MD
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