Provider Demographics
NPI:1134173636
Name:DANVILLE WOMEN'S CARE, P.C.
Entity type:Organization
Organization Name:DANVILLE WOMEN'S CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:CARL
Authorized Official - Last Name:MAUTE
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:434-797-4620
Mailing Address - Street 1:927 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-4001
Mailing Address - Country:US
Mailing Address - Phone:434-797-4620
Mailing Address - Fax:434-793-8992
Practice Address - Street 1:927 S MAIN ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-4001
Practice Address - Country:US
Practice Address - Phone:434-797-4620
Practice Address - Fax:434-793-8992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA051065OtherANTHEM
NC890165EMedicaid
VACM9223OtherRAILROAD MEDICARE
VAC02491Medicare PIN