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Organization

BAYSIDE PEDIATRICS-FULTON, LLC

Active
Parent organization
NOLD AND ESCOBOSA P A
Other names
Bayside Pediatrics
Organization subpart
Yes

Provider details

NPI number
Legal business name
NOLD AND ESCOBOSA P A
Authorized official
JEFFREY NOLD DO (OWNER)
(410) 224-3848
Entity
Organization

Contact information

Practice address
7625 MAPLE LAWN BLVD STE 145, FULTON, MD 20759-2565
(410) 224-7667
Mailing address
2024 WEST ST STE 400, ANNAPOLIS, MD 21401-3552

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1053488841
MD
05
1326096678
MD
05
1376029389
MD
05
1407992407
MD
05
1528104452
MD
05
1710054598
MD
05
1942725064
MD
Enumeration date
04/29/2020
Last updated
08/10/2022
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