Provider Demographics
NPI:1487023297
Name:SHARE THE HEALTH FREE GYNECOLOGY CLINIC, INC.
Entity Type:Organization
Organization Name:SHARE THE HEALTH FREE GYNECOLOGY CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:BILL
Authorized Official - Middle Name:
Authorized Official - Last Name:DICKMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-729-6395
Mailing Address - Street 1:5801 RESEARCH PARK BLVD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-6002
Mailing Address - Country:US
Mailing Address - Phone:608-729-6395
Mailing Address - Fax:
Practice Address - Street 1:5801 RESEARCH PARK BLVD
Practice Address - Street 2:SUITE 400
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-6002
Practice Address - Country:US
Practice Address - Phone:608-729-6395
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-22
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty