Organization
OLD DOMINION PEDIATRICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIC BERNARD FREEMAN MD (PRESIDENT)
(804) 212-1144
Entity
Organization
Contact information
Practice address
9323 MIDLOTHIAN TPKE, SUITE E, NORTH CHESTERFIELD, VA 23235-4942
(804) 212-1144
(888) 681-1473
Mailing address
9323 MIDLOTHIAN TPKE, SUITE E, NORTH CHESTERFIELD, VA 23235-4942
(804) 212-1144
(888) 681-1473
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
0101238680
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010213720
—
VA
05
—
1578577086
—
VA
Enumeration date
07/27/2012
Last updated
07/27/2012
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