Basic Information
| Provider Information | |||||||||
| NPI: | 1821266073 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MARY WASHINGTON HOSPITAL, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1001 SAM PERRY BLVD | ||||||||
| Address2: | |||||||||
| City: | FREDERICKSBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 224014453 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5407411100 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1001 SAM PERRY BLVD | ||||||||
| Address2: | |||||||||
| City: | FREDERICKSBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 224014453 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5407411100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/11/2008 | ||||||||
| LastUpdateDate: | 02/11/2008 | ||||||||
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| AuthorizedOfficialLastName: | RANKIN | ||||||||
| AuthorizedOfficialFirstName: | FRED | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT & CEO | ||||||||
| AuthorizedOfficialTelephone: | 5407411414 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNameSuffix: | III | ||||||||
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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.