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General NPI Number Information
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NPI Number | 1215439526
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Entity Type | Organization
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Legal Business Name | WOMEN'S CHOICE OBGYN LLC
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Dates
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Enumeration Date | 03/02/2018
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Last Update Date | 01/20/2023
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Provider Practice Location Address
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Address Line | 10875 MAIN ST STE 210
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City | FAIRFAX
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State | VA
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Zip | 22030-4732
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Country | US
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Telephone | 703-665-8248
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Fax | 703-665-8248
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Provider Business Mailing Address
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Address Line | 4019 VERRET DR
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City | FAIRFAX
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State | VA
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Zip | 22030-6095
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Country | US
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Telephone | 703-218-2403
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. MITRA ZAMENI
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Credential | MD
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Telephone | 703-218-2403
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 0101261606
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License Number State | VA
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