| NPI | 1508685413 | 
|---|---|
| Doing Business As | KIM KELLY PEDS | 
| Entity Type | Organization | 
| Authorized Contact | DONA BOWIE Office Manager 301-751-0090  | 
| Organization Subpart ? | Yes | 
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care | 
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care | 
| Enumeration Date | 2024-10-08 | 
| Last Update Date | 2024-10-08 |