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General NPI Number Information
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NPI Number | 1417965450
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Entity Type | Organization
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Legal Business Name | NOVA WOMEN'S HEALTHCARE INC
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 07/23/2010
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Provider Practice Location Address
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Address Line | 10400 EATON PL STE 515
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City | FAIRFAX
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State | VA
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Zip | 22030-2234
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Country | US
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Telephone | 703-691-4141
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Fax | 703-591-5663
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Provider Business Mailing Address
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Address Line | 10400 EATON PL STE 515
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City | FAIRFAX
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State | VA
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Zip | 22030-2234
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Country | US
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Telephone | 703-691-4141
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Fax | 703-591-5663
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MI YONG KIM
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Credential |
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Telephone | 703-691-4141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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