The Pediatric Group, PC
NPI #1780808006 in Lake Ridge, Virginia
Provider Information
- NPI Number
- 1780808006
- Entity Type
- Organization
- Organization Name
- The Pediatric Group, PC
- Primary Specialty
- Registered Nurse - Pediatrics
- Enumeration Date
- Apr 11, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 12506 A LAKE RIDGE DRIVE
- City
- Lake Ridge
- State
- Virginia
- ZIP Code
- 22192
- Phone
- (703) 494-4811
Authorized Official
- Name
- MICHAEL GRADER
- Title
- ADMINISTRATOR
- Phone
- (703) 971-6900
Specialties & Taxonomy Codes
| Specialty |
|---|
| Registered Nurse - Pediatrics — Pediatrics |
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