MEDICARE: CENTER FOR WOMEN'S HEALTH AND MINIMALLY INVASIVE SURGERY, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VG0400X	Gynecology Physician	D71550	MD

General Provider Information

NPI Number	:	1447639786
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTER FOR WOMEN'S HEALTH AND MINIMALLY INVASIVE SURGERY, INC.

Provider Business Mailing Address
First Line	:	8714 HICKORY BEND TRL
Second Line	:
City	:	POTOMAC
State	:	MD
Zip	:	20854-2557
Country	:	US
Telephone Number	:	240-688-6097
Fax Number	:

Provider Business Practice Location Address
First Line	:	5530 WISCONSIN AVE STE 914
Second Line	:
City	:	CHEVY CHASE
State	:	MD
Zip	:	20815-4330
Country	:	US
Telephone Number	:	240-688-6097
Fax Number	:

Authorized Official
Title or Position	:	OFFICER
Name	:	DR. SHOBHA SIKKA
Credential	:	M.D.
Telephone Number	:	240-688-6097

Provider Enumeration Date	:	05/19/2015
Last Update Date	:	05/19/2015

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