Provider Demographics
NPI:1730163015
Name:AMERICAN PEDIATRIC CONSULTANTS
Entity type:Organization
Organization Name:AMERICAN PEDIATRIC CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:MILES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-321-1772
Mailing Address - Street 1:PO BOX 70962
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30007-0962
Mailing Address - Country:US
Mailing Address - Phone:770-321-1772
Mailing Address - Fax:770-321-5658
Practice Address - Street 1:4437 BROOKFIELD CORPORATE DR
Practice Address - Street 2:SUITE 203
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-2122
Practice Address - Country:US
Practice Address - Phone:703-560-4930
Practice Address - Fax:703-560-4962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA251E00000X
VA0215000247332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251E00000XAgenciesHome Health
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies