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General NPI Number Information
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NPI Number | 1629342233
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Entity Type | Organization
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Legal Business Name | PEDS CARE LTD
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Dates
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Enumeration Date | 02/28/2012
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Last Update Date | 02/28/2012
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Provider Practice Location Address
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Address Line | 14404 SOMMERVILLE CT
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City | MIDLOTHIAN
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State | VA
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Zip | 23113-6835
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Country | US
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Telephone | 804-536-1332
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2781
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City | CHESTER
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State | VA
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Zip | 23831-8452
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAWED IQBAL
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Credential | M.D
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Telephone | 804-536-1332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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