MEDICARE: MID-ATLANTIC WOMENS CARE PLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician

General Provider Information

NPI Number	:	1568593952
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MID-ATLANTIC WOMENS CARE PLC

Provider Business Mailing Address
First Line	:	667 KINGSBOROUGH SQ STE 200
Second Line	:
City	:	CHESAPEAKE
State	:	VA
Zip	:	23320-4999
Country	:	US
Telephone Number	:	757-436-0167
Fax Number	:	757-436-0236

Provider Business Practice Location Address
First Line	:	667 KINGSBOROUGH SQ STE 200
Second Line	:
City	:	CHESAPEAKE
State	:	VA
Zip	:	23320-4999
Country	:	US
Telephone Number	:	757-436-0167
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT PHYSICIAN
Name	:	DR. GEORGE RECTOR
Credential	:	M.D.
Telephone Number	:	757-436-0167

Provider Enumeration Date	:	03/08/2007
Last Update Date	:	07/17/2019

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