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General NPI Number Information
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NPI Number | 1275907016
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Entity Type | Organization
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Legal Business Name | PREMIER OBGYN INC.
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Dates
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Enumeration Date | 11/17/2015
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Last Update Date | 03/25/2016
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Provider Practice Location Address
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Address Line | 7202 ARLINGTON BLVD SUITE 308
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City | FALLS CHURCH
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State | VA
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Zip | 22042-1859
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Country | US
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Telephone | 703-573-2971
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Fax |
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Provider Business Mailing Address
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Address Line | 7202 ARLINGTON BLVD STE 308 SUITE 308
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City | FALLS CHURCH
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State | VA
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Zip | 22042-1860
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Country | US
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Telephone | 703-573-2971
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Fax |
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | ANNIE T DO
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Credential | M.D
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Telephone | 703-573-2971
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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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