MEDICARE: VIRGO CARTER PEDIATRICS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	D42811	MD
2	208000000X	Pediatrics Physician	D43490	MD

General Provider Information

NPI Number	:	1427185784
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIRGO CARTER PEDIATRICS

Provider Business Mailing Address
First Line	:	1109 SPRING STREET
Second Line	:	SUITE 201
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-4030
Country	:	US
Telephone Number	:	301-565-3999
Fax Number	:	301-576-6259

Provider Business Practice Location Address
First Line	:	1109 SPRING STREET
Second Line	:	SUITE 201
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-4030
Country	:	US
Telephone Number	:	301-565-3999
Fax Number	:	301-576-6259

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GABRIELLE N VIRGO
Credential	:	MD
Telephone Number	:	301-565-3999

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	08/22/2020

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Directions to “VIRGO CARTER PEDIATRICS ” Practice Location

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