Provider Demographics
NPI:1578770160
Name:WOMEN'S HEALTH SPECIALISTS OF MONTGOMERY COUNTY, LLC
Entity Type:Organization
Organization Name:WOMEN'S HEALTH SPECIALISTS OF MONTGOMERY COUNTY, LLC
Other - Org Name:WOMEN'S HEALTH SPECIALISTS OF MONTGOMERY COUNTY, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER MANAGING PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:SNYDER
Authorized Official - Last Name:STEREN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-770-4967
Mailing Address - Street 1:6301 EXECUTIVE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3905
Mailing Address - Country:US
Mailing Address - Phone:301-770-4967
Mailing Address - Fax:301-770-3205
Practice Address - Street 1:6301 EXECUTIVE BLVD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3905
Practice Address - Country:US
Practice Address - Phone:301-770-4967
Practice Address - Fax:301-770-3205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD207VG0400X, 207VX0201X, 208600000X
MDC0001760363A00000X
MDR126791367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty
No207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic OncologyGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1578770160Medicaid