Organization
WALDORF PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CANDICE MICHELLE BOSWELL (OFFICE MANAGER)
(301) 645-1781
Entity
Organization
Contact information
Practice address
4255 ALTAMONT PLACE, SUITE 301, WHITE PLAINS, MD 20695
(301) 645-1781
(301) 374-9237
Mailing address
4255 ALTAMONT PL, #301, WHITE PLAINS, MD 20695
(301) 645-1781
(301) 374-9237
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
D0064240
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
H96241
—
MD
Enumeration date
09/13/2012
Last updated
12/19/2014
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