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General NPI Number Information
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NPI Number | 1699589473
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Entity Type | Organization
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Legal Business Name | CHILDRENS PEDIATRICIANS & ASSOC
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Dates
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Enumeration Date | 02/03/2025
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 3450 OLD WASHINGTON RD STE 100
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City | WALDORF
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State | MD
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Zip | 20602-3249
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Country | US
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Telephone | 301-645-0300
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Fax | 301-645-4009
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Provider Business Mailing Address
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Address Line | PO BOX 744787
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City | ATLANTA
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State | GA
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Zip | 30374-4787
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Country | US
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Telephone | 301-754-3060
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Fax | 301-681-0789
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Authorized Official
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Title or Position | DIRECTOR OF BUSINESS OPERATIONS
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Name | MARK JANOWIAK
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Credential |
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Telephone | 301-572-1382
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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 |
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License Number State |
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