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Contact Information

THE PEDIATRIC GROUP, PC
12506 A LAKE RIDGE DRIVE
LAKE RIDGE, VA22192
 Phone: 703-494-4811
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

163WP0200X
Indicates primary specialty

NPI Profile & details for THE PEDIATRIC GROUP PC · (Female)

NPI # 1780808006
Status Active
Credentials
Entity Individual
Enumeration date 04/11/2007
Last updated 08/22/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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