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General NPI Number Information
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NPI Number | 1053496885
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Entity Type | Organization
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Legal Business Name | SHENANDOAH PEDIATRICS, PC
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1065 S MAIN ST
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City | WOODSTOCK
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State | VA
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Zip | 22664-1041
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Country | US
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Telephone | 540-459-3435
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Fax | 540-459-3536
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Provider Business Mailing Address
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Address Line | 1065 S MAIN ST
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City | WOODSTOCK
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State | VA
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Zip | 22664-1041
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Country | US
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Telephone | 540-459-3435
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Fax | 540-459-3536
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Authorized Official
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Title or Position | OWNER/PHYSICIANS
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Name | DR. SCOTT CHARLES COLE
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Credential | MD
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Telephone | 540-459-9304
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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