Provider Demographics
NPI:1295794998
Name:OB GYN ASSOCIATES LTD
Entity type:Organization
Organization Name:OB GYN ASSOCIATES LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDERIC
Authorized Official - Middle Name:P
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:804-741-0440
Mailing Address - Street 1:7601 FOREST AVE
Mailing Address - Street 2:SUITE 228
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-4933
Mailing Address - Country:US
Mailing Address - Phone:804-741-0440
Mailing Address - Fax:804-288-2277
Practice Address - Street 1:7601 FOREST AVE
Practice Address - Street 2:SUITE 228
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-4933
Practice Address - Country:US
Practice Address - Phone:804-741-0440
Practice Address - Fax:804-288-2277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-21
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C06527OtherMEDICARE GROUP NUMBER