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General NPI Number Information
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NPI Number | 1932229663
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Entity Type | Organization
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Legal Business Name | KIDDIE HEALTH PEDIATRICS, LLC
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 09/27/2011
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Provider Practice Location Address
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Address Line | 1232 RACE RD SUITE 303
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City | BALTIMORE
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State | MD
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Zip | 21237-2351
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Country | US
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Telephone | 410-687-0808
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Fax | 410-687-0070
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Provider Business Mailing Address
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Address Line | PO BOX 70011
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City | BALTIMORE
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State | MD
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Zip | 21237-6011
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Country | US
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Telephone | 410-665-2823
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MELANIE MAGPANTAY GARCIA
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Credential | MD
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Telephone | 410-665-2823
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | M43832
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License Number State | MD
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