Provider Demographics
NPI:1376533810
Name:NEONATOLOGY CENTER OF WINCHESTER
Entity Type:Organization
Organization Name:NEONATOLOGY CENTER OF WINCHESTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:L
Authorized Official - Last Name:CLAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-536-7897
Mailing Address - Street 1:PO BOX 1910
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22604-8060
Mailing Address - Country:US
Mailing Address - Phone:866-878-4221
Mailing Address - Fax:540-536-4359
Practice Address - Street 1:1840 AMHERST ST
Practice Address - Street 2:SUITE 4C
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2808
Practice Address - Country:US
Practice Address - Phone:540-536-7897
Practice Address - Fax:540-536-7843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-26
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD400188500Medicaid
VA120591OtherSOUTHERN HEALTH
VA16566OtherCOMMNUITY HEALTH CHN
PA1881947Medicaid
VA231638OtherANTHEM BC/BS
VA006718442Medicaid
IN200507150AMedicaid
WV3810005227Medicaid
VA16566OtherCOMMNUITY HEALTH CHN
MD400188500Medicaid
VA=========OtherGWHC