Healthcare Provider Details

I. General information

NPI: 1639137979
Provider Name (Legal Business Name): VIRGINIA PHYSICIANS FOR WOMEN LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 10/25/2021
Certification Date: 10/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1212 KOGER CENTER BLVD
NORTH CHESTERFIELD VA
23235-4778
US

IV. Provider business mailing address

1212 KOGER CENTER BLVD
NORTH CHESTERFIELD VA
23235-4778
US

V. Phone/Fax

Practice location:
  • Phone: 804-897-2100
  • Fax: 804-897-9074
Mailing address:
  • Phone: 804-897-2100
  • Fax: 804-897-9074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number StateVA

VIII. Authorized Official

Name: MINDY BURCHETT
Title or Position: CPC
Credential:
Phone: 804-897-2100