Organization
CHILDREN'S MEDICAL GROUP, INC., D/B/A LIBERTY PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHRYN J ABSHIRE (SENIOR VP/CFO)
(757) 668-8565
Entity
Organization
Contact information
Practice address
12705 MCMANUS BLVD, NEWPORT NEWS, VA 23602-4459
(757) 668-4800
(757) 668-4828
Mailing address
606 DENBIGH BLVD, SUITE 400, NEWPORT NEWS, VA 23608-4413
(757) 833-0780
(757) 833-0783
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
174005
ANTHEM
VA
Enumeration date
08/03/2006
Last updated
02/26/2024
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