Provider Demographics
NPI:1659555431
Name:WOMENS HEALTH ASSOCIATES P.C.
Entity Type:Organization
Organization Name:WOMENS HEALTH ASSOCIATES P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:J
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-280-9420
Mailing Address - Street 1:3020 HAMAKER CT
Mailing Address - Street 2:STE B105
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-2238
Mailing Address - Country:US
Mailing Address - Phone:703-280-9420
Mailing Address - Fax:703-280-2747
Practice Address - Street 1:3020 HAMAKER CT STE B105
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-2236
Practice Address - Country:US
Practice Address - Phone:703-280-9420
Practice Address - Fax:703-280-2747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-28
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101043248207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAF42653Medicare UPIN
VAI17315Medicare UPIN
VAGAO708812Medicare PIN