Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 207V00000X | Obstetrics & Gynecology | | 0101049349 | VIRGINIA | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 2265905 | OTHER | | AETNA HMO |
| 2 | 417859 | OTHER | | ALLIANCE PPO |
| 3 | 286929 | OTHER | | AMERIGROUP |
| 4 | 37820001 | OTHER | MARYLAND | CARE FIRST |
| 5 | 344856 | OTHER | | NATIONAL CAPITAL PPO |
| 6 | 417859 | OTHER | | MDIPA OPTIMUM CHOICE |
| 7 | 6211551 | OTHER | VIRGINIA | PREMIER |
| 8 | 6497701 | OTHER | | CIGNA HEALTH PLANS |
| 9 | 417859 | OTHER | | MAMSI HEALTH PLANS |
| 10 | 48004 | OTHER | | COMMUNITY HEALTH CARE |
| 11 | 0005211084 | OTHER | | AETNA PPO |
| 12 | 006211551 | MEDICAID | VIRGINIA | |
| 13 | 204532 | OTHER | VIRGINIA | ANTHEM BLUE SHIELD |
| 14 | 37820001 | OTHER | DISTRICT OF COLUMBIA | CARE FIRST |
