Provider Demographics
NPI:1245543792
Name:CAPTIAL AREA PEDIATRICS, INC
Entity type:Organization
Organization Name:CAPTIAL AREA PEDIATRICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICERV
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:H
Authorized Official - Last Name:WATTS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-359-5160
Mailing Address - Street 1:43480 YUKON DRIVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147
Mailing Address - Country:US
Mailing Address - Phone:703-723-3201
Mailing Address - Fax:703-729-2736
Practice Address - Street 1:43480 YUKON DRIVE
Practice Address - Street 2:SUITE 206
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147
Practice Address - Country:US
Practice Address - Phone:703-723-3201
Practice Address - Fax:703-729-2736
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAPTIAL AREA PEDIATRICS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-07-26
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty