Provider Demographics
NPI:1508939901
Name:WOMANKIND OB/GYN ASSOCIATES
Entity Type:Organization
Organization Name:WOMANKIND OB/GYN ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KACIE
Authorized Official - Middle Name:MARISSA
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-997-6464
Mailing Address - Street 1:8900 COLUMBIA 100 PARKWAY
Mailing Address - Street 2:SUITE E
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045
Mailing Address - Country:US
Mailing Address - Phone:410-997-6464
Mailing Address - Fax:410-997-6867
Practice Address - Street 1:8900 COLUMBIA 100 PARKWAY
Practice Address - Street 2:SUITE E
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045
Practice Address - Country:US
Practice Address - Phone:410-997-6464
Practice Address - Fax:410-997-6867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207V00000X
MDD0035784207V00000X
MDD0046242207V00000X
MDD0018905207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD448300600Medicaid
MD448300600Medicaid
MD143MMedicare PIN