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General NPI Number Information
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NPI Number | 1063389807
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Entity Type | Organization
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Legal Business Name | CHILDREN'S HEART INSTITUTE
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Dates
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Enumeration Date | 10/17/2025
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Last Update Date | 10/17/2025
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Provider Practice Location Address
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Address Line | 97 THOMAS JOHNSON DR STE 202
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City | FREDERICK
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State | MD
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Zip | 21702-4374
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Country | US
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Telephone | 571-612-2600
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Fax | 571-266-4096
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Provider Business Mailing Address
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Address Line | 171 ELDEN ST STE 2C4
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City | HERNDON
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State | VA
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Zip | 20170-4875
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Country | US
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Telephone | 571-612-2600
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Fax | 571-266-4096
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Authorized Official
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Title or Position | PRACTICE ADMIN
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Name | KRISTIE BUTLER-SHUTTS
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Credential |
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Telephone | 571-612-2600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number |
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License Number State |
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