Basic Information
| Provider Information | |||||||||
| NPI: | 1811376957 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NEW RIVER WOMEN'S HEALTH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 210 PROFESSIONAL PARK DRIVE | ||||||||
| Address2: | SUITE 9 | ||||||||
| City: | BLACKSBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 240606649 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5406057566 | ||||||||
| FaxNumber: | 5406057569 | ||||||||
| Practice Location | |||||||||
| Address1: | 210 PROFESSIONAL PARK DR SE | ||||||||
| Address2: | SUITE 9 | ||||||||
| City: | BLACKSBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 240606680 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5406057566 | ||||||||
| FaxNumber: | 5406057569 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/21/2015 | ||||||||
| LastUpdateDate: | 07/24/2015 | ||||||||
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| AuthorizedOfficialLastName: | CAMPBELL | ||||||||
| AuthorizedOfficialFirstName: | SANAM | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5406057566 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.