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General NPI Number Information
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NPI Number | 1366413403
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Entity Type | Individual
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Provider Name | CATRELL OWENS-AGBEIBOR MD
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Gender | Female
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Dates
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Enumeration Date | 01/27/2006
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Last Update Date | 07/25/2012
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Provider Practice Location Address
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Address Line | 5249 OLDE TOWNE RD SUITE D
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City | WILLIAMSBURG
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State | VA
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Zip | 23188-8111
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Country | US
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Telephone | 757-259-3258
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Fax | 757-220-1953
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Provider Business Mailing Address
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Address Line | 5249 OLDE TOWNE RD SUITE D
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City | WILLIAMSBURG
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State | VA
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Zip | 23188-8111
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Country | US
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Telephone | 757-259-3258
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Fax | 757-220-1953
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101245987
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License Number State | VA
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