Provider Demographics
NPI:1992955678
Name:MOUNTAIN VIEW MIDWIVES
Entity type:Organization
Organization Name:MOUNTAIN VIEW MIDWIVES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEREN
Authorized Official - Middle Name:
Authorized Official - Last Name:BADER
Authorized Official - Suffix:
Authorized Official - Credentials:CPM, DRPH
Authorized Official - Phone:434-962-0148
Mailing Address - Street 1:1111 ROSE HILL DR STE 1
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-5168
Mailing Address - Country:US
Mailing Address - Phone:434-962-0148
Mailing Address - Fax:434-566-0133
Practice Address - Street 1:1111 ROSE HILL DR STE 1
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-5168
Practice Address - Country:US
Practice Address - Phone:434-962-0148
Practice Address - Fax:434-566-0133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-30
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0129000005176B00000X
VA0129000003176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty