Provider Demographics
NPI:1902877434
Name:RICHMOND WOMENS CENTER
Entity Type:Organization
Organization Name:RICHMOND WOMENS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:PARVIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:KHOSHNEVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-417-3474
Mailing Address - Street 1:921 LONG DR
Mailing Address - Street 2:STE 202
Mailing Address - City:ROCKINGHAM
Mailing Address - State:NC
Mailing Address - Zip Code:28379
Mailing Address - Country:US
Mailing Address - Phone:910-417-3474
Mailing Address - Fax:910-417-3470
Practice Address - Street 1:921 LONG DR
Practice Address - Street 2:STE 202
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379
Practice Address - Country:US
Practice Address - Phone:910-417-3474
Practice Address - Fax:910-417-3470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-01
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC28525207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
38520OtherTRICARE
NC01712OtherBCBS
NC8948925Medicaid
NC8901712Medicaid
NC8901712Medicaid
NC203525BMedicare PIN