Organization
BOULEVARD CENTER PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANITA GOHEL (PRACTICE MANAGER)
(703) 670-0300
Entity
Organization
Contact information
Practice address
3733 FETTLER PARK DR., DUMFRIES, VA 22025
(703) 670-0300
(703) 291-5331
Mailing address
3733 FETTLER PARK DR., DUMFRIES, VA 22025
(703) 670-0300
(703) 291-5331
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101244499
VA
Other
Enumeration date
11/20/2012
Last updated
02/20/2019
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