Blue Mantle Medicine PLLC
Blue Mantle Medicine PLLC is a Pediatrics Physician in Fairfax, Virginia. Registered with an NPI since 2023.
- In the registry since
- 2023
What do these letters mean?
- PLLC — Professional limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
4001 Fair Ridge Dr Ste 305Fairfax, VA 22033-2917
Phone: (540) 701-4767
Fax: (703) 520-9880
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Pediatrics Physician (primary) | Taxonomy 208000000X |
|---|
Record details
| NPI number | 1417658980 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Sita Canady — Md · (540) 645-1856 |
| NPI enumerated | March 13, 2023 |
| Last updated in NPPES | March 13, 2023 |
| Certification date | March 13, 2023 |
| Mailing address | 4001 Fair Ridge Dr Ste 305, Fairfax, VA 22033-2917 |
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