Healthcare Provider Details
I. General information
NPI: 1568904134
Provider Name (Legal Business Name): SAVANAH RAE SONGER CPM LM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/13/2016
Last Update Date: 11/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4240 OLD CAVE SPRING RD
CAVE SPRING VA
24018-3417
US
IV. Provider business mailing address
4240 OLD CAVE SPRING RD
CAVE SPRING VA
24018-3417
US
V. Phone/Fax
- Phone: 540-339-2841
- Fax: 540-301-1768
- Phone: 540-339-2841
- Fax: 540-301-1768
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 176B00000X |
| Taxonomy | Midwife |
| License Number | 0129000121 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: