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Organization
LAUREL PINE PEDIATRICS LLC
Active
Organization
LAUREL PINE PEDIATRICS LLC
Active
Parent organization
LAUREL PINE PEDIATRICS LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
LAUREL PINE PEDIATRICS LLC
Authorized official
DR. WONDU T. WOSSEN M.D. (PHYSICIAN)
(301) 362-0506
Entity
Organization
Contact information
Practice address
14333 LAUREL BOWIE RD, SUITE 206, LAUREL, MD 20708
(301) 362-0506
(301) 362-6711
Mailing address
14333 LAUREL BOWIE RD, SUITE 206, LAUREL, MD 20708
(301) 362-0506
(301) 362-6711
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
D41251
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
649741100
—
MD
Enumeration date
09/09/2011
Last updated
09/09/2011
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