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Organization

BAY AREA PEDIATRICS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DEMETRIOS JAMES KALLIONGIS MD (PHYSICIAN OWNER)
(410) 643-2275
Entity
Organization

Contact information

Practice address
165 LOG CANOE CIR, SUITE E, STEVENSVILLE, MD 21666-2149
(410) 643-1000
(410) 643-5200
Mailing address
165 LOG CANOE CIR, SUITE E, STEVENSVILLE, MD 21666-2149
(410) 643-1000
(410) 643-5200

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
D0041579
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
407327400
MD
Enumeration date
05/16/2008
Last updated
05/16/2008
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