Provider Demographics
NPI:1871557488
Name:FOXHALL PEDIATRICS PC
Entity type:Organization
Organization Name:FOXHALL PEDIATRICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GUILLERMO
Authorized Official - Middle Name:A
Authorized Official - Last Name:BALFOUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-537-1180
Mailing Address - Street 1:3301 NEW MEXICO AVE NW
Mailing Address - Street 2:STE 238 FOXHALL SQUARE
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016
Mailing Address - Country:US
Mailing Address - Phone:202-537-1180
Mailing Address - Fax:202-244-7410
Practice Address - Street 1:3301 NEW MEXICO AVE NW
Practice Address - Street 2:STE 238 FOXHALL SQUARE
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016
Practice Address - Country:US
Practice Address - Phone:202-537-1180
Practice Address - Fax:202-244-7410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
6436OtherBCBS