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General NPI Number Information
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NPI Number | 1205928587
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Entity Type | Organization
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Legal Business Name | PEDIATRIX MEDICAL GROUP PC
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 1840 AMHERST ST FL 1
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City | WINCHESTER
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State | VA
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Zip | 22601-2808
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Country | US
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Telephone | 540-536-8000
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Fax | 954-851-1948
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Provider Business Mailing Address
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Address Line | PO BOX 100445
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City | ATLANTA
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State | GA
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Zip | 30384-0445
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Country | US
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Telephone | 954-384-0175
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Fax |
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Authorized Official
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Title or Position | ASSISTANT SECRETARY
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Name | NICHOLAS E. GLASER
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Credential |
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Telephone | 954-384-0175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LN0000X
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Taxonomy Name | Neonatal Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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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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Taxonomy #4
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number |
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License Number State |
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