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General NPI Number Information
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NPI Number | 1275571101
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Entity Type | Organization
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Legal Business Name | MID-ATLANTIC WOMENS CARE
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 01/30/2018
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Provider Practice Location Address
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Address Line | 120 KINGS WAY SUITE 3400
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City | WILLIAMSBURG
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State | VA
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Zip | 23185-2505
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Country | US
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Telephone | 757-253-5600
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Fax | 757-253-0819
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Provider Business Mailing Address
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Address Line | 120 KINGS WAY SUITE 3400
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City | WILLIAMSBURG
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State | VA
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Zip | 23185-2505
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Country | US
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Telephone | 757-253-5600
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Fax | 757-253-0819
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SUSAN LONTKOWSKI
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Credential | MD
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Telephone | 757-253-5600
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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 |
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License Number State |
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