Provider Demographics
NPI:1861664120
Name:WEST GYNECOLOGY AND MEDICAL SPA PLC
Entity Type:Organization
Organization Name:WEST GYNECOLOGY AND MEDICAL SPA PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-378-9378
Mailing Address - Street 1:3738 WINTERFIELD RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-9236
Mailing Address - Country:US
Mailing Address - Phone:804-378-9378
Mailing Address - Fax:804-378-9379
Practice Address - Street 1:3738 WINTERFIELD RD
Practice Address - Street 2:SUITE 100
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-9236
Practice Address - Country:US
Practice Address - Phone:804-378-9378
Practice Address - Fax:804-378-9379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101053220207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty