=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043347040
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WOMENS HEALTHCARE GROUP OF PENNSYLVANIA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/27/2007
-----------------------------------------------------
Last Update Date | 06/30/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 100 E LANCASTER AVE SUITE 216 SOUTH
-----------------------------------------------------
City | WYNNEWOOD
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19096-3450
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-658-5266
-----------------------------------------------------
Fax | 610-658-0963
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 100 E LANCASTER AVE SUITE 216 SOUTH
-----------------------------------------------------
City | WYNNEWOOD
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19096-3450
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-658-5266
-----------------------------------------------------
Fax | 610-658-0963
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN
-----------------------------------------------------
Name | DR. SCOTT H BAILEY
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 610-658-5266
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | MD044655E
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------