Healthcare Provider Details

I. General information

NPI: 1023289550
Provider Name (Legal Business Name): KIDSFIRST PEDIATRICS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2008
Last Update Date: 03/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46165 WESTLAKE DR SUITE 210
POTOMAC FALLS VA
20165-5872
US

IV. Provider business mailing address

46165 WESTLAKE DR SUITE 210
POTOMAC FALLS VA
20165-5872
US

V. Phone/Fax

Practice location:
  • Phone: 703-433-1555
  • Fax: 703-444-9830
Mailing address:
  • Phone: 703-433-1555
  • Fax: 703-444-9830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PAULA N FERGUSSON
Title or Position: OWNER
Credential: MD
Phone: 703-433-1555