Organization
PEDIATRIC CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACKSON MAINA NGANGA M.D. (MEDICAL DIRECTOR)
(301) 733-2890
Entity
Organization
Contact information
Practice address
324 E ANTIETAM ST, SUITE 200, HAGERSTOWN, MD 21740-5754
(301) 733-2890
(301) 733-2917
Mailing address
324 E ANTIETAM ST, SUITE 200, HAGERSTOWN, MD 21740-5754
(301) 733-2890
(301) 733-2917
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
05/16/2011
Last updated
05/16/2011
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