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General NPI Number Information
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NPI Number | 1629355250
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Entity Type | Organization
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Legal Business Name | CAPITAL REGION MIDWIFERY, PLLC
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Dates
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Enumeration Date | 11/10/2011
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Last Update Date | 11/10/2011
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Provider Practice Location Address
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Address Line | 2109 15TH ST
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City | TROY
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State | NY
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Zip | 12180-3024
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Country | US
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Telephone | 518-728-7117
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Fax |
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Provider Business Mailing Address
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Address Line | 2109 15TH ST
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City | TROY
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State | NY
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Zip | 12180-3024
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Country | US
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Telephone | 518-728-7117
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARGARET HOLCOMB
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Credential | CNM
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Telephone | 518-728-7117
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number |
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License Number State |
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