Healthcare Provider Details

I. General information

NPI: 1841246899
Provider Name (Legal Business Name): REGIONAL WOMENS HEALTH GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 03/18/2020
Certification Date: 03/18/2020
Deactivation Date: 01/05/2007
Reactivation Date: 03/02/2007

III. Provider practice location address

2401 E EVESHAM RD STE A-1
VOORHEES NJ
08043-9590
US

IV. Provider business mailing address

PO BOX 71404
PHILADELPHIA PA
19176-1404
US

V. Phone/Fax

Practice location:
  • Phone: 856-424-3323
  • Fax: 856-424-4994
Mailing address:
  • Phone: 856-669-6050
  • Fax: 856-651-0794

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: EDWARD C DONOVAN
Title or Position: VP, REVENUE CYCLE
Credential:
Phone: 856-669-6050