DAVIDSONVILLE PEDIATRICS NPI 1679657209

NPI Information

NPI: 1679657209
Provider Name: DAVIDSONVILLE PEDIATRICS
Classification: Non-Pharmacy Dispensing Site - 332900000X
Entity Type: Organization
Doing Business As: DAVIDSONVILLE PEDIATRICS
Address: 2772 RUTLAND RD
DAVIDSONVILLE, MD
ZIP 21035
Phone: (410) 269-7828

Map and Directions

Get Directions

NPI Details

DAVIDSONVILLE PEDIATRICS is a non pharmacy dispensing site in Davidsonville, MD. The provider is a site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) DAVIDSONVILLE PEDIATRICS NPI is 1679657209. The provider is registered as an organization entity type.
The provider Is Doing Business As Davidsonville Pediatrics.

The provider's business location address is:

2772 RUTLAND RD
DAVIDSONVILLE, MD
ZIP 21035-228
Phone: (410) 269-7828
Fax: (410) 269-0510

The provider's authorized official is Direndia Shackelford .
The authorized official title is Managed Care Specialist and has the following contact phone number (800) 654-0889.

The enumeration date for this NPI number is 10/24/2006 and was last updated on 8/22/2020.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	332900000X	Non-Pharmacy Dispensing Site		D0013889	MARYLAND	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	2124410	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER

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: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI

Next NPI