Provider Demographics
NPI:1205802402
Name:PIEDMONT PEDIATRICS, PLC
Entity type:Organization
Organization Name:PIEDMONT PEDIATRICS, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BECKY
Authorized Official - Middle Name:
Authorized Official - Last Name:FITZWATER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-347-3547
Mailing Address - Street 1:20 ROCK POINTE LN
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-2679
Mailing Address - Country:US
Mailing Address - Phone:540-347-9900
Mailing Address - Fax:540-349-0920
Practice Address - Street 1:20 ROCK POINTE LN
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-2679
Practice Address - Country:US
Practice Address - Phone:540-347-9900
Practice Address - Fax:540-349-0920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-27
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty