| Name | Value |
|---|---|
| PROVIDER TYPE | Allopathic & Osteopathic Physicians |
| CLASSIFICATION | Obstetrics & Gynecology |
| DEFINITION | A physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. |
| AREA OF SPECIALIZATION | Gynecology |
| STATUS | Active |
| VA CODE | V181803 |
| X12 CODE | 207VG0400X |
| SPECIALTY CODE | 16 |
| INDIVIDUAL/NON | INDIVIDUAL |
| MASTER ENTRY FOR VUID | YES |
| VUID | 5251769 |
| EFFECTIVE DATE/TIME |
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