Healthcare Provider Details

I. General information

NPI: 1982764411
Provider Name (Legal Business Name): BLUE RIDGE WOMENS CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 01/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 W PICCADILLY ST
WINCHESTER VA
22601-3916
US

IV. Provider business mailing address

130 W PICCADILLY ST
WINCHESTER VA
22601-3916
US

V. Phone/Fax

Practice location:
  • Phone: 540-723-8751
  • Fax: 540-723-8754
Mailing address:
  • Phone: 540-723-8751
  • Fax: 540-723-8754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CEE A DAVID
Title or Position: OWNER
Credential: MD
Phone: 540-723-8751