THE PEDIATRIC GROUP, PC
NPI 1780808006
Registered Nurse - Pediatrics in Lake Ridge, VA
Active since April 11, 2007
About The Pediatric Group, Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
THE PEDIATRIC GROUP, PC (NPI 1780808006) is a healthcare organization registered as a pediatrics in Lake Ridge, Virginia and active in the NPI registry since April 2007. The organization lists Michael Grader, Administrator, as its authorized official.
NPPES Registry Identity
NPI1780808006
Entity TypeOrganization
Primary Taxonomy163WP0200X
Legal Business NameTHE PEDIATRIC GROUP, PC
Location Address12506 A LAKE RIDGE DRIVELake Ridge, VA 22192
Mailing Address7015 C Manchester Blvd.Alexandria, VA 22310
Phone(703) 494-4811
Organization SubpartNo
Authorized OfficialMichael GraderAdministrator · (703) 971-6900
Enumeration DateApril 11, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1780808006 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyRegistered Nurse · PediatricsNursing Service Providers
Taxonomy Code163WP0200X
12506 A LAKE RIDGE DRIVE, Lake Ridge, VA 22192
Group Practice 1
Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1780808006, enumerated as an "organization" on April 11, 2007.
The provider is located at 12506 A LAKE RIDGE DRIVE LAKE RIDGE, VA 22192 and the phone number is (703) 494-4811.
Registered Nurse with taxonomy code 163WP0200X and a focus in Pediatrics.
