Healthcare Provider Details

I. General information

NPI: 1356160196
Provider Name (Legal Business Name): CAPITAL WOMENS CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2024
Last Update Date: 10/08/2024
Certification Date: 10/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9420 KEY WEST AVE STE 415
ROCKVILLE MD
20850-6327
US

IV. Provider business mailing address

PO BOX 81310
CLEVELAND OH
44181-0310
US

V. Phone/Fax

Practice location:
  • Phone: 301-279-9400
  • Fax: 301-309-2428
Mailing address:
  • Phone: 301-340-8339
  • Fax: 304-340-9027

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: MD
Phone: 301-340-8339