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Organization
ADULT AND PEDIATRIC CLINIC, PC
Active
Organization
ADULT AND PEDIATRIC CLINIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAMA MITTAL M.D. (MEDICAL DIRECTOR)
(240) 453-0000
Entity
Organization
Contact information
Practice address
14816 PHYSICIANS LN, SUITE 152, ROCKVILLE, MD 20850-3944
(240) 453-0000
(240) 453-0089
Mailing address
14816 PHYSICIANS LN, SUITE 152, ROCKVILLE, MD 20850-3944
(240) 453-0000
(240) 453-0089
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
D0061382
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002543700
—
MD
Enumeration date
11/06/2007
Last updated
05/14/2008
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