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General NPI Number Information
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NPI Number | 1992955678
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Entity Type | Organization
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Legal Business Name | MOUNTAIN VIEW MIDWIVES
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Dates
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Enumeration Date | 09/30/2008
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Last Update Date | 02/08/2011
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Provider Practice Location Address
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Address Line | 1111 ROSE HILL DR STE 1
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22903-5168
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Country | US
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Telephone | 434-962-0148
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Fax | 434-566-0133
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Provider Business Mailing Address
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Address Line | 1111 ROSE HILL DR STE 1
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22903-5168
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Country | US
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Telephone | 434-962-0148
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Fax | 434-566-0133
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Authorized Official
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Title or Position | PARTNER
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Name | DR. DEREN BADER
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Credential | CPM, DRPH
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Telephone | 434-962-0148
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | 0129000003
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | 0129000005
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License Number State | VA
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