Healthcare Provider Details

I. General information

NPI: 1114748266
Provider Name (Legal Business Name): CAPITAL WOMEN'S CARE, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2024
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

97 THOMAS JOHNSON DR STE 101
FREDERICK MD
21702-4379
US

IV. Provider business mailing address

5801 POSTAL RD
CLEVELAND OH
44181-2184
US

V. Phone/Fax

Practice location:
  • Phone: 301-663-4545
  • Fax: 301-663-1709
Mailing address:
  • Phone: 301-340-8339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DAMON HOU
Title or Position: MEDICAL DIRECTOR
Credential:
Phone: 301-340-8339