Provider Demographics
NPI:1275907016
Name:PREMIER OBGYN INC.
Entity Type:Organization
Organization Name:PREMIER OBGYN INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANNIE
Authorized Official - Middle Name:T
Authorized Official - Last Name:DO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-573-2971
Mailing Address - Street 1:7202 ARLINGTON BLVD STE 308
Mailing Address - Street 2:SUITE 308
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-1860
Mailing Address - Country:US
Mailing Address - Phone:703-573-2971
Mailing Address - Fax:
Practice Address - Street 1:7202 ARLINGTON BLVD
Practice Address - Street 2:SUITE 308
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-1859
Practice Address - Country:US
Practice Address - Phone:703-573-2971
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-17
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty