Organization
INFINITY PEDIATRIC AND ADOLESCENT MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANDRA S. BAUCOM MD (CEO)
(757) 780-8400
Entity
Organization
Contact information
Practice address
1809 S CHURCH ST STE 302, SMITHFIELD, VA 23430-1861
(757) 780-8400
(757) 432-3279
Mailing address
109 SLEEPY RIDGE CT, SUFFOLK, VA 23435-1357
(757) 537-1064
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
01/09/2021
Last updated
01/09/2021
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