Provider Demographics
NPI:1699863498
Name:SPRINGFIELD PEDIATRIC ASSOCIATES, LTD, P.C.
Entity type:Organization
Organization Name:SPRINGFIELD PEDIATRIC ASSOCIATES, LTD, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DOBE (DEBORAH)
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYERGOYZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-451-5200
Mailing Address - Street 1:8348 TRAFORD LN
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22152-1663
Mailing Address - Country:US
Mailing Address - Phone:703-451-5200
Mailing Address - Fax:703-451-0044
Practice Address - Street 1:8348 TRAFORD LN
Practice Address - Street 2:SUITE 301
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22152-1663
Practice Address - Country:US
Practice Address - Phone:703-451-5200
Practice Address - Fax:703-451-0044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty