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General NPI Number Information
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NPI Number | 1497749907
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Entity Type | Individual
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Provider Name | MARIA PETTIT CANTER MD
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Gender | Female
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Dates
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Enumeration Date | 09/12/2005
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Last Update Date | 02/20/2024
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Provider Practice Location Address
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Address Line | 1860 TOWN CENTER DRIVE, SUITE 225
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City | RESTON
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State | VA
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Zip | 20190-5905
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Country | US
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Telephone | 703-293-5239
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Fax | 571-526-4393
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Provider Business Mailing Address
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Address Line | 224-D CORNWALL STREET, NW, SUITE 403
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City | LEESBURG
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State | VA
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Zip | 20176-2704
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Country | US
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Telephone | 703-737-6010
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Fax | 703-443-8643
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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 | 207VF0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
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License Number | 0101239731
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 0101239731
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License Number State | VA
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