Provider Demographics
NPI:1497724058
Name:FOR WOMEN OB-GYN ASSOCIATES
Entity Type:Organization
Organization Name:FOR WOMEN OB-GYN ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:DONALD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-430-7779
Mailing Address - Street 1:11490 COMMERCE PARK DR # 525
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191-1557
Mailing Address - Country:US
Mailing Address - Phone:703-488-6933
Mailing Address - Fax:
Practice Address - Street 1:21135 WHITFIELD PL
Practice Address - Street 2:SUITE 101
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-7279
Practice Address - Country:US
Practice Address - Phone:703-430-7779
Practice Address - Fax:703-262-0906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-16
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101040782207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCG01312Medicare ID - Type UnspecifiedDC MEDICARE
VAC09558Medicare ID - Type UnspecifiedVA MEDICARE