Provider Demographics
NPI:1336570407
Name:PEDIATRIC PARTNERS OF VIRGINIA, LLC
Entity Type:Organization
Organization Name:PEDIATRIC PARTNERS OF VIRGINIA, LLC
Other - Org Name:WEST END PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PHIL
Authorized Official - Middle Name:
Authorized Official - Last Name:DAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-740-6171
Mailing Address - Street 1:9606 PATTERSON AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-6027
Mailing Address - Country:US
Mailing Address - Phone:804-740-6171
Mailing Address - Fax:
Practice Address - Street 1:9606 PATTERSON AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-6027
Practice Address - Country:US
Practice Address - Phone:804-740-6171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PEDIATRIC PARTNERS OF VIRGINIA, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-11-27
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty