Organization
MAIN STREET PEDIATRICS, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODY LEVISON (OFFICE MANAGER)
(410) 494-2799
Entity
Organization
Contact information
Practice address
515 FAIRMOUNT AVE, SUITE 200, TOWSON, MD 21286-5466
(410) 494-1369
Mailing address
515 FAIRMOUNT AVE, SUITE 200, TOWSON, MD 21286-5466
(410) 494-1369
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
04/06/2007
Last updated
08/22/2020
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