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General NPI Number Information
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NPI Number | 1265543631
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Entity Type | Organization
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Legal Business Name | BLUE RIDGE PEDIATRICS ASSOCIATES LTD
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 03/12/2009
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Provider Practice Location Address
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Address Line | 337 WESTSIDE STATION DRIVE
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City | WINCHESTER
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State | VA
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Zip | 22601
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Country | US
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Telephone | 540-667-5400
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Fax | 540-722-9516
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Provider Business Mailing Address
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Address Line | 337 WESTSIDE STATION DRIVE
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City | WINCHESTER
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State | VA
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Zip | 22601
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Country | US
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Telephone | 540-667-5400
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Fax | 540-722-9516
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Authorized Official
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Title or Position | PRESIDENT BLUE RIDGE PEDIATRIC ASSO
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Name | DANIEL C SCHIAVONE JR.
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Credential | MD
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Telephone | 540-667-5400
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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 | 0101029741
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License Number State | VA
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