# PEDIATRIC TLC, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225573413
- **Authorized official:** DR. MOHAMMAD TARIQ M.D (PRESIDENT)
- **Authorized official phone:** (301) 331-7882

## Contact information

- **Practice address:** 334 MILL ST, HAGERSTOWN, MD 21740-6138
- **Practice address phone:** (301) 393-9170
- **Practice address fax:** (301) 393-9173
- **Mailing address:** 334 MILL ST, HAGERSTOWN, MD 21740-6138
- **Mailing address phone:** (301) 393-9170
- **Mailing address fax:** (301) 393-9173

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080A0000X | Pediatric Adolescent Medicine Physician | D0064771 | MD | Yes |

## Other

- **Enumeration date:** 12/27/2016
- **Last updated:** 12/27/2016