| Name | Value |
|---|---|
| PROVIDER TYPE | Allopathic & Osteopathic Physicians |
| CLASSIFICATION | Pediatrics |
| DEFINITION | A pediatrician who has special qualifications to manage emergencies in infants and children. |
| AREA OF SPECIALIZATION | Pediatric Emergency Medicine |
| STATUS | Active |
| VA CODE | V182510 |
| X12 CODE | 2080P0204X |
| SPECIALTY CODE | 37 |
| INDIVIDUAL/NON | INDIVIDUAL |
| MASTER ENTRY FOR VUID | YES |
| VUID | 5251874 |
| EFFECTIVE DATE/TIME |
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