MEDICARE: SAVANAH RAE SONGER CPM LM

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	176B00000X	Midwife	0129000121	VA

General Provider Information

NPI Number	:	1568904134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAVANAH RAE SONGER CPM LM

Provider Business Mailing Address
First Line	:	4240 OLD CAVE SPRING RD
Second Line	:
City	:	CAVE SPRING
State	:	VA
Zip	:	24018-3417
Country	:	US
Telephone Number	:	540-339-2841
Fax Number	:	540-301-1768

Provider Business Practice Location Address
First Line	:	4240 OLD CAVE SPRING RD
Second Line	:
City	:	CAVE SPRING
State	:	VA
Zip	:	24018-3417
Country	:	US
Telephone Number	:	540-339-2841
Fax Number	:	540-301-1768

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/13/2016
Last Update Date	:	11/13/2016

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