Provider Demographics
NPI:1891945069
Name:PEDIATRIC PARTNERS OF SOUTHERN MARYLAND, PA
Entity Type:Organization
Organization Name:PEDIATRIC PARTNERS OF SOUTHERN MARYLAND, PA
Other - Org Name:DR. PEDRO SARMIENTO, JR.
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:SARMIENTO
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:410-286-2990
Mailing Address - Street 1:11885 HOLLY LN
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20601-3181
Mailing Address - Country:US
Mailing Address - Phone:301-843-8989
Mailing Address - Fax:301-645-9442
Practice Address - Street 1:11885 HOLLY LN
Practice Address - Street 2:SUITE 1
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20601-3181
Practice Address - Country:US
Practice Address - Phone:301-843-8989
Practice Address - Fax:301-645-9442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-24
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0039620208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty