Ettienne'S Premier Pediatric Care Llc

LBN: Ettienne'S Premier Pediatric Care Llc
Ettienne'S Premier Pediatric Care Llc is an health care organization with primary practice located at 2905 Mitchellville Rd Ste 115, Bowie MD 20716-1385. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as the primary health care specialty. Ettienne'S Premier Pediatric Care Llc can be contacted via phone (301) 390-7960, or through Ettienne, Suzette Scipio via phone (301) 390-7960.

Contact Information

Primary practice address
2905 Mitchellville Rd Ste 115 Bowie MD 20716-1385
Phone: (301) 390-7960
Fax: (301) 218-2800
Website:
Map and Directions
Authorized official contact:
Name: Ettienne, Suzette Scipio Doctor of Medicine (MD)
Phone: (301) 390-7960

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X D0046373 Maryland

Profile Details

NPI number 1841408697
LBN Legal business name Ettienne'S Premier Pediatric Care Llc
DBA Doing business as
Authorized official Ettienne, Suzette Scipio Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date May 17th, 2007
Last updated Dec 12th, 2013 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841408697 NPPES
Maryland MEDICAID 363101000

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