Provider Demographics
NPI:1023179314
Name:METROPOLITAN WOMEN'S GROUP, LLC
Entity Type:Organization
Organization Name:METROPOLITAN WOMEN'S GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHRYN
Authorized Official - Middle Name:T
Authorized Official - Last Name:GRAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-585-8796
Mailing Address - Street 1:1111 SPRING STREET
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910
Mailing Address - Country:US
Mailing Address - Phone:301-585-8796
Mailing Address - Fax:301-565-8079
Practice Address - Street 1:7701 GREENBELT ROAD
Practice Address - Street 2:SUITE 503
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770
Practice Address - Country:US
Practice Address - Phone:301-513-0200
Practice Address - Fax:301-513-0555
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:METROPOLITAN WOMEN'S GROUP, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-12
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDOO50472207V00000X
MDDOO48033207V00000X
MDDOO50606207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDA699Medicaid
DCG400OtherBCBS
MD3000-01Medicaid
MD462200OtherANTHEM
MDKEN7MEOtherBCBS
MD400599600Medicaid