Provider Demographics
NPI:1275628414
Name:HIRSCH PEDIATRICS, LLC
Entity Type:Organization
Organization Name:HIRSCH PEDIATRICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:FLINT
Authorized Official - Last Name:HIRSCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-990-3030
Mailing Address - Street 1:15235 SHADY GROVE RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3234
Mailing Address - Country:US
Mailing Address - Phone:301-990-3030
Mailing Address - Fax:301-990-6767
Practice Address - Street 1:15235 SHADY GROVE RD
Practice Address - Street 2:SUITE 105
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3234
Practice Address - Country:US
Practice Address - Phone:301-990-3030
Practice Address - Fax:301-990-6767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0060026208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD409917600Medicaid
I50041Medicare UPIN
018984C95Medicare ID - Type Unspecified