Healthcare Provider Details

I. General information

NPI: 1679658363
Provider Name (Legal Business Name): ADULT AND PEDIATRIC HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 ELDEN ST SUITE 10
HERNDON VA
20170-4873
US

IV. Provider business mailing address

100 ELDEN ST SUITE 10
HERNDON VA
20170-4873
US

V. Phone/Fax

Practice location:
  • Phone: 703-689-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number0101031802
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number0101031802
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code207KI0005X
TaxonomyClinical & Laboratory Immunology (Allergy & Immunology) Physician
License Number0101031802
License Number StateVA
# 4
Primary TaxonomyY
Taxonomy Code2080P0201X
TaxonomyPediatric Allergy/Immunology Physician
License Number0101031803
License Number StateVA

VIII. Authorized Official

Name: DR. DONNA SCHUSTER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 703-689-2000