Provider Demographics
NPI:1417974338
Name:CALDWELL PEDIATRICS AND WELLNESS CENTER PC
Entity Type:Organization
Organization Name:CALDWELL PEDIATRICS AND WELLNESS CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MELANEY
Authorized Official - Middle Name:ARMSTRONG
Authorized Official - Last Name:CALDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-520-0002
Mailing Address - Street 1:2425 BOULEVARD
Mailing Address - Street 2:SUITE #6
Mailing Address - City:COLONIAL HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:23834-2324
Mailing Address - Country:US
Mailing Address - Phone:804-520-0002
Mailing Address - Fax:804-520-2259
Practice Address - Street 1:2425 BOULEVARD
Practice Address - Street 2:SUITE #6
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834-2324
Practice Address - Country:US
Practice Address - Phone:804-520-0002
Practice Address - Fax:804-520-2259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101054172208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty