=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578863502
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WESTERN BRANCH CENTER FOR WOMEN PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/25/2010
-----------------------------------------------------
Last Update Date | 10/25/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3806 POPLAR HILL RD SUITE B
-----------------------------------------------------
City | CHESAPEAKE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23321-5533
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-484-7200
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3806 POPLAR HILL RD SUITE B
-----------------------------------------------------
City | CHESAPEAKE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23321-5533
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-484-7200
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEDICAL DIRECTOR
-----------------------------------------------------
Name | DR. BUNAN ALNAIF
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 757-484-7200
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | 0101059316
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------