Healthcare Provider Details

I. General information

NPI: 1194171090
Provider Name (Legal Business Name): FOXCARE INTEGRATIVE PEDIATRICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2016
Last Update Date: 05/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41135 WHITFIELD PLACE SUITE 107
STERLING VA
20165-7279
US

IV. Provider business mailing address

PO BOX 17334
BALTIMORE MD
21297-1334
US

V. Phone/Fax

Practice location:
  • Phone: 703-421-7000
  • Fax: 703-430-4830
Mailing address:
  • Phone: 703-443-6717
  • Fax: 703-443-8643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: REBECCA R FOX
Title or Position: PRESIDENT
Credential: M.D.
Phone: 703-421-7000