Provider Demographics
NPI:1073634853
Name:CAROLINA WOMANCARE P.A.
Entity Type:Organization
Organization Name:CAROLINA WOMANCARE P.A.
Other - Org Name:CAROLINA BIRTH CENTER MIDWIFERY ASSOCIATES
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-889-5422
Mailing Address - Street 1:712 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-3918
Mailing Address - Country:US
Mailing Address - Phone:336-889-5422
Mailing Address - Fax:336-889-9993
Practice Address - Street 1:712 N ELM ST
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-3918
Practice Address - Country:US
Practice Address - Phone:336-889-5422
Practice Address - Fax:336-889-9993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14634174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0102QOtherCWC BCBS
NC890102QMedicaid
NC890102QMedicaid