Healthcare Provider Details

I. General information

NPI: 1386886497
Provider Name (Legal Business Name): BRITTANY GOLDBERG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2009
Last Update Date: 04/01/2024
Certification Date: 04/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8280 WILLOW OAKS CORPORATE DR STE 300
FAIRFAX VA
22031-4526
US

IV. Provider business mailing address

PO BOX 37215
BALTIMORE MD
21297-3215
US

V. Phone/Fax

Practice location:
  • Phone: 571-472-4300
  • Fax:
Mailing address:
  • Phone: 202-476-6151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License NumberMD040434
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License NumberMD040434
License Number StateDC
# 3
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number0101260026
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: