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General NPI Number Information
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NPI Number | 1831891282
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Entity Type | Organization
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Legal Business Name | CARONETTE FIBROID & PELVIC WELLNESS CENTER
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Dates
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Enumeration Date | 03/20/2023
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 11886 HEALING WAY STE 520
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City | SILVER SPRING
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State | MD
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Zip | 20904-7917
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Country | US
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Telephone | 706-662-3129
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Fax |
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Provider Business Mailing Address
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Address Line | 11406 DAIRY ST
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City | FULTON
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State | MD
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Zip | 20759-2661
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Country | US
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Telephone | 706-662-3129
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DR. OTIS LAWRENCE SITT III
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Credential | MD
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Telephone | 706-662-3129
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State |
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