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General NPI Number Information
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NPI Number | 1891990776
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Entity Type | Organization
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Legal Business Name | COVENANT OBSTETRICS AND GYNECOLOGY PC
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Dates
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Enumeration Date | 06/19/2007
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Last Update Date | 10/25/2007
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Provider Practice Location Address
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Address Line | 596 RADIO HILL RD
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City | MARION
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State | VA
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Zip | 24354-4224
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Country | US
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Telephone | 276-783-7868
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Fax |
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Provider Business Mailing Address
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Address Line | 596 RADIO HILL RD
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City | MARION
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State | VA
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Zip | 24354-4224
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Country | US
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Telephone | 276-783-7868
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CINDY J PARKER
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Credential | MD
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Telephone | 276-783-7868
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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 | 0101240074
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License Number State | VA
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