Healthcare Provider Details

I. General information

NPI: 1134173636
Provider Name (Legal Business Name): DANVILLE WOMEN'S CARE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 12/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

927 S MAIN ST
DANVILLE VA
24541-4001
US

IV. Provider business mailing address

927 S MAIN ST
DANVILLE VA
24541-4001
US

V. Phone/Fax

Practice location:
  • Phone: 434-797-4620
  • Fax: 434-793-8992
Mailing address:
  • Phone: 434-797-4620
  • Fax: 434-793-8992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. FREDERICK CARL MAUTE III
Title or Position: PRESIDENT
Credential: M.D.
Phone: 434-797-4620