Organization
PEDIATRIC CONSULTANTS, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ROSEMARIE T MARTIN (CFO)
(410) 785-0333
Entity
Organization
Contact information
Practice address
10807 FALLS RD, SUITE 200, LUTHERVILLE, MD 21093-4591
(410) 321-9393
(410) 825-4945
Mailing address
10807 FALLS RD, SUITE 200, LUTHERVILLE, MD 21093-4591
(410) 321-9393
(410) 825-4945
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H253PE
BLUE SHIELD OF MD
MD
Enumeration date
03/27/2008
Last updated
03/27/2008
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