Healthcare Provider Details
I. General information
NPI: 1497564009
Provider Name (Legal Business Name): WHITE OAK PEDIATRICS DRS BATTIATA & IMPEDUGLIA PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/07/2025
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
18310 MONTGOMERY VILLAGE AVE STE 460
GAITHERSBURG MD
20879-3565
US
IV. Provider business mailing address
11161 NEW HAMPSHIRE AVE STE 301
SILVER SPRING MD
20904-2606
US
V. Phone/Fax
- Phone: 301-977-4100
- Fax: 855-885-1472
- Phone: 301-681-7101
- Fax: 855-885-1472
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
GIOVANNI
IMPEDUGLIA
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 301-681-7101