Provider Demographics
NPI:1568506228
Name:OBSTETRICAL AND GYNECOLOGICAL GROUP PA
Entity Type:Organization
Organization Name:OBSTETRICAL AND GYNECOLOGICAL GROUP PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:NEIL
Authorized Official - Last Name:POWERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-835-8363
Mailing Address - Street 1:PO BOX 631001
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21263-1001
Mailing Address - Country:US
Mailing Address - Phone:202-835-8363
Mailing Address - Fax:202-467-4487
Practice Address - Street 1:2440 M ST NW
Practice Address - Street 2:SUITE 510
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1404
Practice Address - Country:US
Practice Address - Phone:202-835-8363
Practice Address - Fax:202-467-4487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2008-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC409880Medicare PIN