Healthcare Provider Details

I. General information

NPI: 1851498398
Provider Name (Legal Business Name): CHILDRENS CHOICE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5562 COUGAR TRAIL ROAD
DUBLIN VA
24084
US

IV. Provider business mailing address

PO BOX 969
DUBLIN VA
24084-0969
US

V. Phone/Fax

Practice location:
  • Phone: 540-674-8900
  • Fax: 540-674-9121
Mailing address:
  • Phone: 540-674-8900
  • Fax: 540-674-9121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101050249
License Number StateVA

VIII. Authorized Official

Name: DR. RICHARD C GEHRZ
Title or Position: PRESIDENT
Credential: M.D.
Phone: 540-674-8900