Healthcare Provider Details

I. General information

NPI: 1710139316
Provider Name (Legal Business Name): WHITE OAK PEDIATRICS DRS BATTIATA & IMPEDUGLIA PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2008
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11161 NEW HAMPSHIRE AVE STE 301
SILVER SPRING MD
20904-2606
US

IV. Provider business mailing address

11161 NEW HAMPSHIRE AVE #301
SILVER SPRING MD
20904
US

V. Phone/Fax

Practice location:
  • Phone: 301-681-7101
  • Fax: 301-681-8127
Mailing address:
  • Phone: 301-681-7101
  • Fax: 301-681-8127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0036322
License Number StateMD

VIII. Authorized Official

Name: GIOVANNI IMPEDUGLIA
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 301-681-7101