Healthcare Provider Details

I. General information

NPI: 1376533810
Provider Name (Legal Business Name): NEONATOLOGY CENTER OF WINCHESTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2005
Last Update Date: 07/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 AMHERST ST SUITE 4C
WINCHESTER VA
22601-2808
US

IV. Provider business mailing address

PO BOX 1910
WINCHESTER VA
22604-8060
US

V. Phone/Fax

Practice location:
  • Phone: 540-536-7897
  • Fax: 540-536-7843
Mailing address:
  • Phone: 866-878-4221
  • Fax: 540-536-4359

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. TERESA L CLAWSON
Title or Position: PRESIDENT
Credential: MD
Phone: 540-536-7897