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ADULT AND PEDIATRIC CLINIC PC NPI 1497935605


NPI Information

NPI: 1497935605
Provider Name: ADULT AND PEDIATRIC CLINIC, PC
Classification: General Practice - 208D00000X
Entity Type: Organization

CLIA Number: 21D1037671

Address:
14816 PHYSICIANS LN
SUITE 152
ROCKVILLE, MD
ZIP 20850
Phone: (240) 453-0000
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ADULT AND PEDIATRIC CLINIC, PC is a general practice in Rockville, MD. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee ADULT AND PEDIATRIC CLINIC, PC NPI is 1497935605. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

14816 PHYSICIANS LN
SUITE 152
ROCKVILLE, MD
ZIP 20850-944
Phone: (240) 453-0000
Fax: (240) 453-0089

The provider's authorized official is Shama Mittal .
The authorized official title is Medical Director and has the following contact phone number (240) 453-0000.

The CLIA number assigned to this NPI record is 21D1037671 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/6/2007 and was last updated on 5/14/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208D00000XGeneral PracticeD0061382MARYLANDYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1G01826MEDICARE PIN
2G56524MEDICARE UPIN
3002543700MEDICAIDMARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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