Provider Demographics
NPI:1043726664
Name:QUINCE ORCHARD PEDIATRICS
Entity Type:Organization
Organization Name:QUINCE ORCHARD PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:B
Authorized Official - Last Name:HUNSINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-987-1560
Mailing Address - Street 1:11906 DARNESTOWN RD STE F
Mailing Address - Street 2:
Mailing Address - City:NORTH POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20878-2200
Mailing Address - Country:US
Mailing Address - Phone:301-987-1560
Mailing Address - Fax:301-987-5817
Practice Address - Street 1:11906 DARNESTOWN RD STE F
Practice Address - Street 2:
Practice Address - City:NORTH POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20878-2200
Practice Address - Country:US
Practice Address - Phone:301-987-1560
Practice Address - Fax:301-987-5817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-19
Last Update Date:2017-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0035634261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD7638418P0001Medicaid