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BOULEVARD CENTER PEDIATRICS NPI 1568706158


NPI Information

NPI: 1568706158
Provider Name: BOULEVARD CENTER PEDIATRICS
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 49D0692122

Address:
3733 FETTLER PARK DR.
DUMFRIES, VA
ZIP 22025
Phone: (703) 670-0300
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BOULEVARD CENTER PEDIATRICS is a pediatrics in Dumfries, VA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. BOULEVARD CENTER PEDIATRICS NPI is 1568706158. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3733 FETTLER PARK DR.
DUMFRIES, VA
ZIP 22025
Phone: (703) 670-0300
Fax: (703) 291-5331

The provider's authorized official is Anita Gohel .
The authorized official title is Practice Manager and has the following contact phone number (703) 670-0300.

The CLIA number assigned to this NPI record is 49D0692122 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/20/2012 and was last updated on 2/20/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatrics0101244499VIRGINIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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