Provider Demographics
NPI:1700975349
Name:CAPITAL AREA PEDIATRICS, INC
Entity Type:Organization
Organization Name:CAPITAL AREA PEDIATRICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER/MEDICAL DIR
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 1:10461 WHITE GRANITE DRIVE
Mailing Address - Street 2:STE. 210
Mailing Address - City:OAKTON
Mailing Address - State:VA
Mailing Address - Zip Code:22124
Mailing Address - Country:US
Mailing Address - Phone:703-359-5160
Mailing Address - Fax:703-383-9574
Practice Address - Street 1:10461 WHITE GRANITE DRIVE
Practice Address - Street 2:STE. 210
Practice Address - City:OAKTON
Practice Address - State:VA
Practice Address - Zip Code:22124
Practice Address - Country:US
Practice Address - Phone:703-359-5160
Practice Address - Fax:703-383-9574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty