1295827293 NPI number — METROPOLITAN PEDIATRICS, LLC

Table of content: (NPI 1295827293)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295827293 NPI number — METROPOLITAN PEDIATRICS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
METROPOLITAN PEDIATRICS, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1295827293
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11125 ROCKVILLE PIKE
Provider Second Line Business Mailing Address:
SUITE 209
Provider Business Mailing Address City Name:
N BETHESDA
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20852-3142
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-230-2280
Provider Business Mailing Address Fax Number:
301-230-2245

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11125 ROCKVILLE PIKE
Provider Second Line Business Practice Location Address:
SUITE 209
Provider Business Practice Location Address City Name:
N BETHESDA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20852-3142
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-230-2280
Provider Business Practice Location Address Fax Number:
301-230-2245
Provider Enumeration Date:
09/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SWANSON
Authorized Official First Name:
DAWN
Authorized Official Middle Name:
S
Authorized Official Title or Position:
PRACTICE ADMINISTRATOR
Authorized Official Telephone Number:
301-230-2280

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  D0053243 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 9418214 . This is a "PHCS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: J575 0002 . This is a "BCBS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 601 AME . This is a "BCBS OF MD" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 1952305872 . This is a "NPI DR KULP" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 6513183 . This is a "CIGNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 9892352 . This is a "CIGNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 7234782 . This is a "AETNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 1326026659 . This is a "NPI DR KUSKOWSKI" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 7925383 . This is a "AETNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: J575 0001 . This is a "BCBS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 1183339 . This is a "AETNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 2112424 . This is a "UHC" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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