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General NPI Number Information
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NPI Number | 1205802402
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Entity Type | Organization
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Legal Business Name | PIEDMONT PEDIATRICS, PLC
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Dates
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Enumeration Date | 02/27/2006
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Last Update Date | 04/26/2016
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Provider Practice Location Address
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Address Line | 20 ROCK POINTE LN
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City | WARRENTON
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State | VA
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Zip | 20186-2679
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Country | US
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Telephone | 540-347-9900
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Fax | 540-349-0920
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Provider Business Mailing Address
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Address Line | 20 ROCK POINTE LN
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City | WARRENTON
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State | VA
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Zip | 20186-2679
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Country | US
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Telephone | 540-347-9900
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Fax | 540-349-0920
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MRS. BECKY FITZWATER
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Credential |
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Telephone | 540-347-3547
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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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