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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

BLUE MANTLE MEDICINE PLLC

Active Organization

BLUE MANTLE MEDICINE PLLC is a Pediatrics organization located in FAIRFAX, Virginia. NPI 1417658980 is currently active in the NPPES registry. Verify at CMS.

Pediatrics · FAIRFAX, VA

Registration Details

NPI Number
1417658980
Provider Type
Organization
NPI Issued
Mar 13, 2023 (3.3779596663592 yrs)
Last Updated
Mar 13, 2023

Practice Information

Address
4001 FAIR RIDGE DR STE 305
FAIRFAX, VA, 220332917
Browse VA providers · Browse ZIP 22033
Phone
5407014767
Fax
7035209880
Primary Specialty
Pediatrics
208000000X
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.