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Organization

CHILDREN'S MEDICAL CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. FAUZIA F. QUDDUS M.D. (PRESIDENT)
(228) 832-0414
Entity
Organization

Contact information

Practice address
15465 OAK LN, SUITE 100 F, GULFPORT, MS 39503-2663
(228) 832-0414
(228) 832-8227
Mailing address
15465 OAK LN, SUITE 100 F, GULFPORT, MS 39503-2663
(228) 832-0414
(228) 832-8227

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
14692
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09014469
MS
Enumeration date
10/22/2007
Last updated
06/13/2008
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