| NPI | 1861131906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA E AIKEN-GOODWIN Credentialing Manager 571-472-6253 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207RC0200X Internal Medicine, Critical Care Medicine | |
| 207T00000X Neurological Surgery | |
| 207V00000X Obstetrics & Gynecology | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma | |
| 208000000X Pediatrics | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine | |
| 2080P0210X Pediatrics, Pediatric Nephrology | |
| 2086S0127X Surgery, Trauma Surgery | |
| 363L00000X Nurse Practitioner | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2022-05-27 |
| Last Update Date | 2026-08-27 |