Organization
PEDIATRIX OF MARYLAND PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS E. GLASER (ASSISTANT SECRETARY)
(954) 384-0175
Entity
Organization
Contact information
Practice address
12500 WILLOWBROOK RD, CUMBERLAND, MD 21502-6393
(240) 964-7000
Mailing address
PO BOX 100445, ATLANTA, GA 30384-0445
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
445000107
—
MD
Enumeration date
05/06/2024
Last updated
11/04/2024
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