Provider Demographics
NPI:1437175197
Name:WOMEN'S CENTER OB/GYN
Entity Type:Organization
Organization Name:WOMEN'S CENTER OB/GYN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-869-2220
Mailing Address - Street 1:455 WOODVIEW RD, SUITE 230
Mailing Address - Street 2:PO BOX 9
Mailing Address - City:WEST GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19390
Mailing Address - Country:US
Mailing Address - Phone:610-869-2220
Mailing Address - Fax:610-869-6550
Practice Address - Street 1:455 WOODVIEW RD STE 230
Practice Address - Street 2:
Practice Address - City:WEST GROVE
Practice Address - State:PA
Practice Address - Zip Code:19390-9301
Practice Address - Country:US
Practice Address - Phone:610-869-2220
Practice Address - Fax:610-869-6550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD063660-L174400000X
207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000100764920Medicaid
PAG98744Medicare UPIN
PA028790Medicare ID - Type Unspecified
PA000100764920Medicaid