Provider Demographics
NPI:1093952277
Name:WHOLE CHILD PEDIATRICS
Entity Type:Organization
Organization Name:WHOLE CHILD PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SOKOLOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-723-8900
Mailing Address - Street 1:20925 PROFESSIONAL PLZ
Mailing Address - Street 2:SUTIE #340
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-3403
Mailing Address - Country:US
Mailing Address - Phone:703-723-8900
Mailing Address - Fax:
Practice Address - Street 1:20925 PROFESSIONAL PLZ
Practice Address - Street 2:SUTIE #340
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-3403
Practice Address - Country:US
Practice Address - Phone:703-723-8900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-09
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty