# KINGSKIDS PHYSICIANS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** KINGSKIDS PHYSICIANS, LLC
- **Other names:** KingsKids Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1144696220
- **Legal business name:** KINGSKIDS PHYSICIANS, LLC
- **Authorized official:** MR. SUNDAY CHUKS OKPARAOCHA (OFFICE MANAGER)
- **Authorized official phone:** (443) 653-1229

## Contact information

- **Practice address:** 13932 BALTIMORE AVE, 11, LAUREL, MD 20707-5000
- **Practice address phone:** (443) 653-1229
- **Practice address fax:** (410) 315-7868
- **Mailing address:** 13932 BALTIMORE AVE, 11, LAUREL, MD 20707-5000
- **Mailing address phone:** (443) 653-1229
- **Mailing address fax:** (410) 315-7868

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080A0000X | Pediatric Adolescent Medicine Physician | D0064420 | MD | Yes |

## Other

- **Enumeration date:** 08/12/2015
- **Last updated:** 08/12/2015