Provider Demographics
NPI:1689771818
Name:MID-ATLANTIC WOMENS CARE PLC
Entity Type:Organization
Organization Name:MID-ATLANTIC WOMENS CARE PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OBAID
Authorized Official - Middle Name:
Authorized Official - Last Name:JAFRI
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:757-722-7401
Mailing Address - Street 1:4000 COLISEUM DR
Mailing Address - Street 2:SUITE 280
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-5906
Mailing Address - Country:US
Mailing Address - Phone:757-722-7401
Mailing Address - Fax:757-722-7404
Practice Address - Street 1:4000 COLISEUM DR
Practice Address - Street 2:SUITE 280
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-5906
Practice Address - Country:US
Practice Address - Phone:757-722-7401
Practice Address - Fax:757-722-7404
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MID-ATLANTIC WOMENS CARE PLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006208398Medicaid
VA010174341Medicaid
VA006290671Medicaid
VA006216935Medicaid
VA006208398Medicaid