Civista Pediatric Hospitalist Group

NPI #1841525540 in La Plata, Maryland

Provider Information

NPI Number: 1841525540
Entity Type: Organization
Organization Name: Civista Pediatric Hospitalist Group
Subpart: Yes (part of a larger organization)
Parent Organization: CIVISTA MEDICAL CENTER
Primary Specialty: Pediatrics
Enumeration Date: Oct 14, 2009
Last Updated: Oct 22, 2009

Practice Location

Address: 5 GARRETT AVE
City: La Plata
State: Maryland
ZIP Code: 20646-5960
Phone: (301) 609-4000

Authorized Official

Name: MR. ERIK BOAS
Title: CHIEF FINANCIAL OFFICER
Phone: (301) 609-4130

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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