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General NPI Number Information
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NPI Number | 1376928234
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Entity Type | Organization
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Legal Business Name | COUNTY PEDIATRICS, P.L.L.C.
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Dates
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Enumeration Date | 07/21/2015
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Last Update Date | 07/21/2015
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Provider Practice Location Address
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Address Line | 2109 HARPERS ML
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City | WILLIAMSBURG
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State | VA
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Zip | 23185-7521
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Country | US
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Telephone | 757-903-5074
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Fax |
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Provider Business Mailing Address
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Address Line | 6420 GEORGE WASHINGTON MEM HWY STE B
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City | YORKTOWN
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State | VA
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Zip | 23692-2180
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Country | US
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Telephone | 757-969-6544
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Fax | 757-969-6545
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Authorized Official
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Title or Position | PROVIDER
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Name | DR. BINA A FENN
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Credential | M.D.
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Telephone | 757-969-6544
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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 | 0101246193
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License Number State | VA
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