Provider Demographics
NPI:1871557744
Name:NORTHWEST PEDIATRICS INC
Entity type:Organization
Organization Name:NORTHWEST PEDIATRICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MDS RACC
Authorized Official - Phone:636-441-7280
Mailing Address - Street 1:11 GARVEY PARKWAY
Mailing Address - Street 2:
Mailing Address - City:ST CHARLES
Mailing Address - State:MD
Mailing Address - Zip Code:63303-5614
Mailing Address - Country:US
Mailing Address - Phone:636-441-7280
Mailing Address - Fax:636-926-0560
Practice Address - Street 1:11 GARVEY PARKWAY
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:MD
Practice Address - Zip Code:63303-5614
Practice Address - Country:US
Practice Address - Phone:636-441-7280
Practice Address - Fax:636-926-0560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty