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Organization

KINGSKIDS PHYSICIANS, LLC

Active
Parent organization
KINGSKIDS PHYSICIANS, LLC
Other names
KingsKids Clinic
Organization subpart
Yes

Provider details

NPI number
Legal business name
KINGSKIDS PHYSICIANS, LLC
Authorized official
MR. SUNDAY CHUKS OKPARAOCHA (OFFICE MANAGER)
(443) 653-1229
Entity
Organization

Contact information

Practice address
13932 BALTIMORE AVE, 11, LAUREL, MD 20707-5000
(443) 653-1229
(410) 315-7868
Mailing address
13932 BALTIMORE AVE, 11, LAUREL, MD 20707-5000
(443) 653-1229
(410) 315-7868

Taxonomy

Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
D0064420
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
335147500
MD
Enumeration date
08/12/2015
Last updated
08/12/2015
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