Provider Demographics
NPI:1639658420
Name:WASHINGTON INTERNATIONAL PEDIATRICS LLC
Entity Type:Organization
Organization Name:WASHINGTON INTERNATIONAL PEDIATRICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SABINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DE LA CROIX-VAUBOIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-792-5260
Mailing Address - Street 1:4808 MOORLAND LN STE 109
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-6131
Mailing Address - Country:US
Mailing Address - Phone:301-792-5260
Mailing Address - Fax:
Practice Address - Street 1:4808 MOORLAND LANE
Practice Address - Street 2:SUITE 109
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814
Practice Address - Country:US
Practice Address - Phone:301-792-5260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-13
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty