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General NPI Number Information
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NPI Number | 1699054858
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Entity Type | Organization
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Legal Business Name | GENERATIONS OF WOMEN OBGYN PC
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Dates
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Enumeration Date | 08/05/2011
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Last Update Date | 02/19/2014
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Provider Practice Location Address
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Address Line | 1300 HOSPITAL DR SUITE 302
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-8451
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Country | US
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Telephone | 540-654-8400
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Fax | 540-322-3086
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Provider Business Mailing Address
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Address Line | 1300 HOSPITAL DR SUITE 302
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-8451
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Country | US
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Telephone | 540-654-8400
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Fax | 540-322-3086
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Authorized Official
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Title or Position | PRESIDENT
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Name | BARBARA MERCADO-STALLARD
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Credential | MD
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Telephone | 540-654-8400
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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 | 0101059310
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License Number State | VA
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