Provider Demographics
NPI:1316701204
Name:ABOVE & BEYOND PEDIATRICS
Entity type:Organization
Organization Name:ABOVE & BEYOND PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TUERE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUGHES-KAPENZI
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MBA
Authorized Official - Phone:301-818-3799
Mailing Address - Street 1:12070 OLD LINE CTR STE 212
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-2567
Mailing Address - Country:US
Mailing Address - Phone:301-710-0455
Mailing Address - Fax:301-710-9406
Practice Address - Street 1:8700 CENTRAL AVE STE 203
Practice Address - Street 2:
Practice Address - City:LANDOVER
Practice Address - State:MD
Practice Address - Zip Code:20785-4868
Practice Address - Country:US
Practice Address - Phone:301-710-0455
Practice Address - Fax:301-710-9406
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ABOVE & BEYOND PEDIATRICS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty