Healthcare Provider Details

I. General information

NPI: 1093459240
Provider Name (Legal Business Name): PELEX, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2022
Last Update Date: 12/02/2022
Certification Date: 12/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

931 DOUGLASS DR
MC LEAN VA
22101-1572
US

IV. Provider business mailing address

931 DOUGLASS DR
MC LEAN VA
22101-1572
US

V. Phone/Fax

Practice location:
  • Phone: 202-421-0120
  • Fax: 855-492-1610
Mailing address:
  • Phone: 202-421-0120
  • Fax: 855-492-1610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ERIN FORAN WOLFF
Title or Position: FOUNDER, CEO
Credential: MD,FACOG
Phone: 202-421-0120