=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689496143
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CAPITAL WOMEN'S CARE, L.L.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/28/2024
-----------------------------------------------------
Last Update Date | 10/28/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 826 WASHINGTON ROAD SUITE 130
-----------------------------------------------------
City | WESTMINISTER
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21157
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-876-2003
-----------------------------------------------------
Fax | 410-848-3009
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5801 POSTAL ROAD
-----------------------------------------------------
City | CLEVELAND
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44181-0310
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-340-8339
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEDICAL DIRECTOR
-----------------------------------------------------
Name | DAMON HOU
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 301-340-8339
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------