Provider Demographics
NPI:1780639096
Name:CECIL COUNTY PEDIATRICS
Entity Type:Organization
Organization Name:CECIL COUNTY PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DDONG
Authorized Official - Middle Name:HEE
Authorized Official - Last Name:PARK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-398-2700
Mailing Address - Street 1:719 N BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921-5309
Mailing Address - Country:US
Mailing Address - Phone:410-398-2700
Mailing Address - Fax:410-620-1249
Practice Address - Street 1:719 N BRIDGE ST
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-5309
Practice Address - Country:US
Practice Address - Phone:410-398-2700
Practice Address - Fax:410-620-1249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty