Organization
ANNAPOLIS PEDIATRICS
Active
Other names
ANNAPOLIS PEDIATRICS
Organization subpart
No
Provider details
NPI number
Authorized official
DIRENDIA SHACKELFORD (MANAGED CARE SPECIALIST)
(800) 654-0889
Entity
Organization
Contact information
Practice address
200 FORBES ST, ANNAPOLIS, MD 21401-1538
(410) 263-6363
(410) 263-7551
Mailing address
200 FORBES ST, ANNAPOLIS, MD 21401-1538
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
D0008186
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2124713
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
10/23/2006
Last updated
08/22/2020
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