Provider Demographics
NPI:1558418053
Name:PEDIATRIC SPECIALISTS OF ANNAPOLIS, LLP
Entity Type:Organization
Organization Name:PEDIATRIC SPECIALISTS OF ANNAPOLIS, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:G
Authorized Official - Last Name:GRAW
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:443-607-1033
Mailing Address - Street 1:2772 RUTLAND RD
Mailing Address - Street 2:
Mailing Address - City:DAVIDSONVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21035-1228
Mailing Address - Country:US
Mailing Address - Phone:443-607-1033
Mailing Address - Fax:443-607-1041
Practice Address - Street 1:2772 RUTLAND RD
Practice Address - Street 2:
Practice Address - City:DAVIDSONVILLE
Practice Address - State:MD
Practice Address - Zip Code:21035-1228
Practice Address - Country:US
Practice Address - Phone:410-451-1800
Practice Address - Fax:410-269-0510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-OncologyGroup - Multi-Specialty