Healthcare Provider Details

I. General information

NPI: 1629355250
Provider Name (Legal Business Name): CAPITAL REGION MIDWIFERY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2011
Last Update Date: 11/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2109 15TH ST
TROY NY
12180-3024
US

IV. Provider business mailing address

2109 15TH ST
TROY NY
12180-3024
US

V. Phone/Fax

Practice location:
  • Phone: 518-728-7117
  • Fax:
Mailing address:
  • Phone: 518-728-7117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State

VIII. Authorized Official

Name: MARGARET HOLCOMB
Title or Position: OWNER
Credential: CNM
Phone: 518-728-7117