Organization
BURKE PEDIATRICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FREDRIC GARNER MD (MANGING PARTNER)
(703) 978-6061
Entity
Organization
Contact information
Practice address
8988 FERN PARK DR, BURKE, VA 22015-1635
(703) 978-6061
(703) 978-0291
Mailing address
8988 FERN PARK DR, BURKE, VA 22015-1635
(703) 978-6061
(703) 978-0291
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
0101017927
VA
261QP2300X
Primary Care Clinic/Center
0101025357
VA
261QP2300X
Primary Care Clinic/Center
0101053539
VA
261QP2300X
Primary Care Clinic/Center
0101240590
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006707033
—
VA
05
—
006727352
—
VA
05
—
010074941
—
VA
05
—
6712355
—
VA
Enumeration date
03/09/2012
Last updated
03/09/2012
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