Organization
DONALD W. WICZER, M.D., GEORGE M. KORENGOLD, M.D., VANESSA M. MAYOL
Active
Other names
Bethesda Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE M. KORENGOLD M.D. (PRESIDENT)
(301) 299-8930
Entity
Organization
Contact information
Practice address
11325 SEVEN LOCKS ROAD, # 238, POTOMAC, MD 20854
(301) 299-8930
(301) 299-8933
Mailing address
11325 SEVEN LOCKS ROAD, # 238, POTOMAC, MD 20854
(301) 299-8930
(301) 299-8933
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
D0017886
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
910821100
—
MD
01
—
C043
CAREFIRST/BLUE CHOICE
DC
01
—
S962
CAREFIRST OF MD
MD
Enumeration date
08/31/2006
Last updated
07/22/2008
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