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General NPI Number Information
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NPI Number | 1659555431
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Entity Type | Organization
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Legal Business Name | WOMENS HEALTH ASSOCIATES P.C.
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Dates
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Enumeration Date | 12/28/2007
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Last Update Date | 11/03/2011
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Provider Practice Location Address
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Address Line | 3020 HAMAKER CT STE B105
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City | FAIRFAX
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State | VA
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Zip | 22031-2236
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Country | US
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Telephone | 703-280-9420
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Fax | 703-280-2747
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Provider Business Mailing Address
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Address Line | 3020 HAMAKER CT STE B105
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City | FAIRFAX
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State | VA
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Zip | 22031-2238
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Country | US
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Telephone | 703-280-9420
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Fax | 703-280-2747
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | MS. CHERYL J JACKSON
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Credential |
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Telephone | 703-280-9420
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 0101043248
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License Number State | VA
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