Provider Demographics
NPI:1003964149
Name:WESTAR OBSTETRICS AND GYNECOLOGY LLC
Entity Type:Organization
Organization Name:WESTAR OBSTETRICS AND GYNECOLOGY LLC
Other - Org Name:WESTAR OB GYN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MURNANE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-818-0300
Mailing Address - Street 1:444 N CLEVELAND AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-8387
Mailing Address - Country:US
Mailing Address - Phone:614-818-0300
Mailing Address - Fax:614-818-0313
Practice Address - Street 1:444 N CLEVELAND AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-8387
Practice Address - Country:US
Practice Address - Phone:614-818-0300
Practice Address - Fax:614-818-0313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.057055207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
07-01508OtherUNITEDHEALTHCARE
OC04918OtherNATIONWIDE
OH271663810009OtherMEDICAL MUTUAL
7208431OtherAETNA
OC04918OtherNATIONWIDE
E92010Medicare UPIN
=========-2A11OtherANTHEM