Healthcare Provider Details

I. General information

NPI: 1447071568
Provider Name (Legal Business Name): CAPITAL WOMEN'S CARE, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2024
Last Update Date: 10/21/2024
Certification Date: 10/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6569 N CHARLES ST STE 610
TOWSON MD
21204-5807
US

IV. Provider business mailing address

PO BOX 81310
CLEVELAND OH
44181-0310
US

V. Phone/Fax

Practice location:
  • Phone: 410-821-7676
  • Fax: 410-825-7205
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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

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