Provider Demographics
NPI:1093731689
Name:KIDS CHOICE PEDIATRICS, P.C.
Entity Type:Organization
Organization Name:KIDS CHOICE PEDIATRICS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SUZANNE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-710-6006
Mailing Address - Street 1:10411 COURTHOUSE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:SPOTSYLVANIA
Mailing Address - State:VA
Mailing Address - Zip Code:22553-1798
Mailing Address - Country:US
Mailing Address - Phone:540-710-6006
Mailing Address - Fax:540-710-6001
Practice Address - Street 1:10411 COURTHOUSE RD
Practice Address - Street 2:SUITE A
Practice Address - City:SPOTSYLVANIA
Practice Address - State:VA
Practice Address - Zip Code:22553-1798
Practice Address - Country:US
Practice Address - Phone:540-710-6006
Practice Address - Fax:540-710-6001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101058461208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty