Provider Demographics
NPI:1689872327
Name:PESCE, NOEL VETTICAD (MD)
Entity Type:Individual
Prefix:
First Name:NOEL
Middle Name:VETTICAD
Last Name:PESCE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14138 FLINT ROCK RD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20853-2653
Mailing Address - Country:US
Mailing Address - Phone:301-460-1422
Mailing Address - Fax:
Practice Address - Street 1:2401 BLUERIDGE AVE
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:MD
Practice Address - Zip Code:20902-4517
Practice Address - Country:US
Practice Address - Phone:301-933-6440
Practice Address - Fax:301-933-5923
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2011-11-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD00677812080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine