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Organization
PEDIATRIX MEDICAL GROUP PC
Active
Organization
PEDIATRIX MEDICAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS E. GLASER (ASSISTANT SECRETARY)
(954) 384-0175
Entity
Organization
Contact information
Practice address
1840 AMHERST ST FL 1, WINCHESTER, VA 22601-2808
(540) 536-8000
(954) 851-1948
Mailing address
PO BOX 100445, ATLANTA, GA 30384-0445
(954) 384-0175
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
—
NULL
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
—
—
231H00000X
Audiologist
—
NULL
231H00000X
Audiologist
—
—
363LN0000X
Neonatal Nurse Practitioner
—
NULL
363LN0000X
Neonatal Nurse Practitioner
—
—
Other
Enumeration date
09/28/2006
Last updated
07/24/2025
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