| Medpeds, Llc | |
|
7350 Van Dusen Rd Ste 130 Laurel MD 20707-5267 | |
| (301) 498-8880 | |
| (301) 498-7939 |
| Full Name | Medpeds, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 7350 Van Dusen Rd Ste 130, Laurel, Maryland |
| Authorized Official Name and Position | Seth Eaton (PRESIDENT) |
| Authorized Official Contact | 3014988880 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medpeds, Llc 7350 Van Dusen Rd Ste 130 Laurel MD 20707-5267 Ph: (301) 498-8880 | Medpeds, Llc 7350 Van Dusen Rd Ste 130 Laurel MD 20707-5267 Ph: (301) 498-8880 |
| NPI Number | 1093838609 |
|---|---|
| Provider Enumeration Date | 04/09/2007 |
| Last Update Date | 10/28/2010 |
| Medicare PECOS PAC ID | 9537352554 |
|---|---|
| Medicare Enrollment ID | O20101022000901 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093838609 | NPI | - | NPPES |
| G00330 | Medicaid | DC |
| Provider Name | Reema Jalali |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649339177 PECOS PAC ID: 4183816952 Enrollment ID: I20101012000646 |
| Provider Name | Jill Carol Rosenstock |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306905823 PECOS PAC ID: 5890988711 Enrollment ID: I20101022000990 |
| Provider Name | Seth R Eaton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700945128 PECOS PAC ID: 0345433264 Enrollment ID: I20101022001036 |
| Provider Name | Angela E Duncan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104985548 PECOS PAC ID: 7517150436 Enrollment ID: I20101022001098 |
| Provider Name | Deborah Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871652313 PECOS PAC ID: 8123213121 Enrollment ID: I20101117000021 |
| Provider Name | Meagan Lopes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437439213 PECOS PAC ID: 3678737269 Enrollment ID: I20120612000066 |
| Provider Name | Kathryn F Penn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295011377 PECOS PAC ID: 9931363462 Enrollment ID: I20120614000113 |
| Provider Name | Ansu Punnoose |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235496233 PECOS PAC ID: 6608179676 Enrollment ID: I20160126000094 |
| Provider Name | Soma Mitra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386679603 PECOS PAC ID: 6709881121 Enrollment ID: I20200227000231 |
| Provider Name | Susanna E Winston |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194942433 PECOS PAC ID: 2062604226 Enrollment ID: I20220401001364 |
| Provider Name | Nikki K Garren |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265888036 PECOS PAC ID: 4385938802 Enrollment ID: I20230831002251 |
| Provider Name | Andrew Alan Bombardier |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821339649 PECOS PAC ID: 6305166109 Enrollment ID: I20231214001437 |
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