Organization
MED-PED HEALTH CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMAL FADUL MD (MEDICAL DIRECTOR)
(301) 441-4400
Entity
Organization
Contact information
Practice address
6201 GREENBELT RD, SUITE M16, BERWYN HEIGHTS, MD 20740-2354
(301) 441-4400
(301) 441-3008
Mailing address
6201 GREENBELT RD, SUITE M-16, BERWYN HEIGHTS, MD 20740-2354
(301) 441-4400
(301) 441-3008
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0062057
—
MD
Enumeration date
01/05/2007
Last updated
12/18/2023
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