# PRIME PEDIATRICS, LLC

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

## Provider details

- **NPI number:** 1316286032
- **Authorized official:** DR. FARNOUSH JAMALI M.D. (OWNER)
- **Authorized official phone:** (301) 977-2440

## Contact information

- **Practice address:** 845 QUINCE ORCHARD BLVD STE B, GAITHERSBURG, MD 20878-1676
- **Practice address phone:** (301) 977-2440
- **Practice address fax:** (301) 977-4752
- **Mailing address:** 845 QUINCE ORCHARD BLVD STE B, GAITHERSBURG, MD 20878-1676
- **Mailing address phone:** (301) 977-2440
- **Mailing address fax:** (301) 977-4752

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080A0000X | Pediatric Adolescent Medicine Physician | D0058375 | MD | Yes |

## Other

- **Enumeration date:** 02/01/2013
- **Last updated:** 02/01/2013