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General NPI Number Information
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NPI Number | 1801186622
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Entity Type | Organization
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Legal Business Name | POTOMAC VALLEY PEDIATRICS
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Dates
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Enumeration Date | 04/13/2011
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Last Update Date | 04/13/2011
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Provider Practice Location Address
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Address Line | 11908 DARNESTOWN RD SUTE G & H
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City | NORTH POTOMAC
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State | MD
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Zip | 20878-2295
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Country | US
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Telephone | 301-990-6333
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Fax | 301-519-0474
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Provider Business Mailing Address
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Address Line | 11908 DARNESTOWN RD SUTE G & H
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City | NORTH POTOMAC
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State | MD
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Zip | 20878-2295
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Country | US
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Telephone | 301-990-6333
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Fax | 301-519-0474
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Authorized Official
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Title or Position | PHYSICIAN/ OWNER
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Name | DR. AVNEET K BAWA
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Credential | M,D.
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Telephone | 301-990-6333
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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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