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General NPI Number Information
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NPI Number | 1831310820
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Entity Type | Organization
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Legal Business Name | THE PHYSICIAN AND MIDWIFE COLLABORATIVE PRACTICE
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 4660 KENMORE AVE SUITE 902
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City | ALEXANDRIA
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State | VA
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Zip | 22304-1313
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Country | US
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Telephone | 703-370-4300
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Fax | 703-370-1683
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Provider Business Mailing Address
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Address Line | 4660 KENMORE AVE SUITE 902
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City | ALEXANDRIA
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State | VA
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Zip | 22304-1313
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Country | US
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Telephone | 703-370-4300
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Fax | 703-370-1683
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | VICTORIA DODSON
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Credential |
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Telephone | 443-398-0189
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number |
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License Number State |
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