Organization
VIRGINIA PEDIATRIC & ADOLESCENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICK CHRISTENSEN (ADMINISTRATOR)
(703) 569-8400
Entity
Organization
Contact information
Practice address
8316 TRAFORD LN, SPRINGFIELD, VA 22152-1654
(703) 569-8400
(703) 569-1182
Mailing address
8316 TRAFORD LN, SPRINGFIELD, VA 22152-1654
(703) 569-8400
(703) 569-1182
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
90012
AETNA
—
01
—
B939
CAREFIRST BCBS
—
Enumeration date
05/18/2007
Last updated
08/22/2020
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