Provider Demographics
NPI:1831328970
Name:LAUREL CHILDREN'S CLINIC
Entity type:Organization
Organization Name:LAUREL CHILDREN'S CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NITIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOPDE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-776-9000
Mailing Address - Street 1:PO BOX 2889
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20709-2889
Mailing Address - Country:US
Mailing Address - Phone:301-776-9000
Mailing Address - Fax:301-776-9259
Practice Address - Street 1:13932 BALTIMORE AVE
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5000
Practice Address - Country:US
Practice Address - Phone:301-776-9000
Practice Address - Fax:301-776-9259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-10
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0046333208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty