Provider Demographics
NPI:1649330838
Name:CLARKSBURG PEDIATRICS, L.L.C.
Entity type:Organization
Organization Name:CLARKSBURG PEDIATRICS, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEAD PEDIATRICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ARMINA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-528-8181
Mailing Address - Street 1:23218 BREWERS TAVERN WAY
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20871-4391
Mailing Address - Country:US
Mailing Address - Phone:301-528-8181
Mailing Address - Fax:301-528-8282
Practice Address - Street 1:23218 BREWERS TAVERN WAY
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:MD
Practice Address - Zip Code:20871-4391
Practice Address - Country:US
Practice Address - Phone:301-528-8181
Practice Address - Fax:301-528-8282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD59444208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty