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Organization

THE PEDIATRIC GROUP, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PATRICIA RIVERS (PRACTICE ADMINISTRATOR)
(703) 971-6900
Entity
Organization

Contact information

Practice address
7015C MANCHESTER BLVD, ALEXANDRIA, VA 22310-3253
(703) 971-6900
(703) 971-9184
Mailing address
7015C MANCHESTER BLVD, ALEXANDRIA, VA 22310-3253
(703) 971-6900
(703) 971-9184

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1205884434
E. LIN, MD
VA
01
1225096373
E. CAVROS, MD
VA
01
1235187725
E. PALUMBO, MD
VA
01
1255399382
N. LEYKAM, MD
VA
01
1407814403
T. GARRETT, MD
VA
01
1427016864
V. GIANNUZZI, MD
VA
01
1689632028
C. FUGATE, MD
VA
01
1700844701
A. KAPOOR, MD
VA
Enumeration date
06/10/2006
Last updated
08/22/2020
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