Basic Information
| Provider Information | |||||||||
| NPI: | 1881626653 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CUMBERLAND VALLEY OBSTETRICS & GYNECOLOGY, P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9 FLOWERS DR | ||||||||
| Address2: | |||||||||
| City: | MECHANICSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170501701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7176918750 | ||||||||
| FaxNumber: | 7176918755 | ||||||||
| Practice Location | |||||||||
| Address1: | 9 FLOWERS DR | ||||||||
| Address2: | |||||||||
| City: | MECHANICSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170501701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7176918750 | ||||||||
| FaxNumber: | 7176918755 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2006 | ||||||||
| LastUpdateDate: | 04/27/2011 | ||||||||
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| AuthorizedOfficialLastName: | BUSH | ||||||||
| AuthorizedOfficialFirstName: | JODY | ||||||||
| AuthorizedOfficialMiddleName: | LYNN | ||||||||
| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 7176918750 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | MD029681E | PA | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.