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General NPI Number Information
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NPI Number | 1649362351
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Entity Type | Organization
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Legal Business Name | PHYSICIANS TO CHILDREN, INC.
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 21 HIGHLAND AVE SE SUITE 100
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City | ROANOKE
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State | VA
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Zip | 24013-2201
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Country | US
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Telephone | 540-344-9213
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Fax | 540-855-9178
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Provider Business Mailing Address
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Address Line | 21 HIGHLAND AVE SE SUITE 100
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City | ROANOKE
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State | VA
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Zip | 24013-2201
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Country | US
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Telephone | 540-344-9213
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Fax | 540-855-9178
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. SARA E PERDUE
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Credential |
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Telephone | 540-855-9142
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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 | VA
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