Provider Demographics
NPI:1346398807
Name:THE WOMEN'S GROUP OF GWINNETT, P.C.
Entity Type:Organization
Organization Name:THE WOMEN'S GROUP OF GWINNETT, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:D
Authorized Official - Last Name:HABERSTROH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:770-979-4700
Mailing Address - Street 1:1700 TREE LN
Mailing Address - Street 2:SUITE 230
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-6782
Mailing Address - Country:US
Mailing Address - Phone:770-979-4700
Mailing Address - Fax:770-979-1060
Practice Address - Street 1:1700 TREE LN
Practice Address - Street 2:SUITE 230
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-6782
Practice Address - Country:US
Practice Address - Phone:770-979-4700
Practice Address - Fax:770-979-1060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty