Organization
PEDIATRIX MEDICAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS E. GLASER (ASSISTANT SECRETARY)
(800) 243-3839
Entity
Organization
Contact information
Practice address
800 PENNSYLVANIA AVE, CHARLESTON, WV 25302-3351
(304) 388-2252
Mailing address
1301 CONCORD TER, SUNRISE, FL 33323-2843
(800) 243-3839
(844) 686-2961
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
—
—
2080P0203X
Pediatric Critical Care Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007020000
—
WV
Enumeration date
07/26/2006
Last updated
08/21/2024
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