# PEDIATRIX MEDICAL GROUP PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992728117
- **Authorized official:** NICHOLAS E. GLASER (ASSISTANT SECRETARY)
- **Authorized official phone:** (800) 243-3839

## Contact information

- **Practice address:** 800 PENNSYLVANIA AVE, CHARLESTON, WV 25302-3351
- **Practice address phone:** (304) 388-2252
- **Mailing address:** 1301 CONCORD TER, SUNRISE, FL 33323-2843
- **Mailing address phone:** (800) 243-3839
- **Mailing address fax:** (844) 686-2961

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080N0001X | Neonatal-Perinatal Medicine Physician | — | NULL | Yes |
| 2080N0001X | Neonatal-Perinatal Medicine Physician | — | — | Yes |
| 2080P0203X | Pediatric Critical Care Medicine Physician | — | NULL | — |
| 2080P0203X | Pediatric Critical Care Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 07/26/2006
- **Last updated:** 08/21/2024