Healthcare Provider Details

I. General information

NPI: 1285655886
Provider Name (Legal Business Name): WOMEN OBGYN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2003 MEDICAL PKWY SUITE 250
ANNAPOLIS MD
21401-7992
US

IV. Provider business mailing address

2003 MEDICAL PKWY SUITE 250
ANNAPOLIS MD
21401-7992
US

V. Phone/Fax

Practice location:
  • Phone: 410-224-2228
  • Fax: 410-266-7778
Mailing address:
  • Phone: 410-224-2228
  • Fax: 410-266-7778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number StateMD

VIII. Authorized Official

Name: DR. MIRIAM YUDKOFF
Title or Position: PRESIDENT
Credential: M.D.
Phone: 410-224-2228