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General NPI Number Information
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NPI Number | 1679469431
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Entity Type | Organization
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Legal Business Name | PM PEDIATRICS OF MARYLAND LLC
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Dates
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Enumeration Date | 06/17/2025
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 6630 MARIE CURIE DR
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City | ELKRIDGE
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State | MD
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Zip | 21075-6402
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Country | US
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Telephone | 571-370-5437
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Fax |
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Provider Business Mailing Address
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Address Line | 1 HOLLOW LANE SUITE 301
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City | LAKE SUCCESS
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State | NY
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Zip | 11042
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Country | US
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Telephone | 516-207-7936
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Fax |
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Authorized Official
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Title or Position | SENIOR MANAGER
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Name | DANIELLE MARIE LOPEZ
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Credential |
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Telephone | 516-207-7936
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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