Provider Demographics
NPI:1790242618
Name:THE CENTER FOR CONCEPTION AND PELVIC SURGERY, INC
Entity Type:Organization
Organization Name:THE CENTER FOR CONCEPTION AND PELVIC SURGERY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:OLUYEMISI
Authorized Official - Middle Name:
Authorized Official - Last Name:FAMUYIWA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-442-8548
Mailing Address - Street 1:3202 TOWER OAKS BLVD STE 370B
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4219
Mailing Address - Country:US
Mailing Address - Phone:240-460-9987
Mailing Address - Fax:
Practice Address - Street 1:3202 TOWER OAKS BLVD STE 370B
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4219
Practice Address - Country:US
Practice Address - Phone:240-460-9987
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-27
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology