Provider Demographics
NPI:1497994776
Name:WOMENS OB GYN, PC
Entity Type:Organization
Organization Name:WOMENS OB GYN, PC
Other - Org Name:MID LEVEL PROVIDERS
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT OF CORPORATION
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:M
Authorized Official - Last Name:MINNEC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-792-3100
Mailing Address - Street 1:5400 MACKINAW RD
Mailing Address - Street 2:SUITE 6100
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48604-9515
Mailing Address - Country:US
Mailing Address - Phone:989-792-3100
Mailing Address - Fax:989-792-9860
Practice Address - Street 1:5400 MACKINAW RD
Practice Address - Street 2:SUITE 6100
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-9515
Practice Address - Country:US
Practice Address - Phone:989-792-3100
Practice Address - Fax:989-792-9860
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WOMENS OB GYN, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-02-11
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty