The Pediatric and Adolescent Center, LLC

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

D0050819 Issued in MD

Legal business name

THE PEDIATRIC AND ADOLESCENT CENTER, LLC

Practice address

12164 Central Ave
Suite 227
Mitchellville, MD 20721-1944

Phone

(301) 218-3700

Fax

(301) 218-3909

NPI assigned

Mar 21, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Clifford Michael Galanis, M.D.NPI 1306881271

Title

Owner

Phone

(301) 218-3700

Specialties & licenses 1

Addresses

Other names 1

• The Pediatric & Adolescent Center, LLC Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Clifford Michael Galanis, M.D.

  • Pediatrics Physician
  • Glenn Dale, MD
  • NPI 1306881271

  Adolescent Medicine

  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750407862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12164 CENTRAL AVE",
            "address_2": "SUITE 227",
            "city": "MITCHELLVILLE",
            "state": "MD",
            "postal_code": "207211944",
            "telephone_number": "301-218-3700",
            "fax_number": "301-218-3909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12164 CENTRAL AVE",
            "address_2": "SUITE 227",
            "city": "MITCHELLVILLE",
            "state": "MD",
            "postal_code": "207211944",
            "telephone_number": "301-218-3700",
            "fax_number": "301-218-3909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PEDIATRIC AND ADOLESCENT CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GALANIS",
        "authorized_official_first_name": "CLIFFORD",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-218-3700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MD",
            "license": "D0050819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Pediatric & Adolescent Center, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Pediatric Adolescent Medicine Physician in Mitchellville, MD
• Providers in Mitchellville, MD by specialty
• Pediatric Adolescent Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.