| Civista Women's Health Center | |
|
11315 Pembrooke Sq Ste 111 Waldorf MD 20603-4806 | |
| (301) 843-3150 | |
| (301) 843-2560 |
| Full Name | Civista Women's Health Center |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 11315 Pembrooke Sq Ste 111, Waldorf, Maryland |
| Authorized Official Name and Position | Ivette M Montes De Oca (PRACTICE MANAGER) |
| Authorized Official Contact | 3018433150 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Civista Women's Health Center 5 Garrett Avenue Po Box 1070 La Plata MD 20646-1070 Ph: (301) 609-4000 | Civista Women's Health Center 11315 Pembrooke Sq Ste 111 Waldorf MD 20603-4806 Ph: (301) 843-3150 |
| NPI Number | 1831417476 |
|---|---|
| Provider Enumeration Date | 05/06/2010 |
| Last Update Date | 12/17/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831417476 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | D0065304 (Maryland) | Primary |
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