Provider Demographics
NPI:1578767851
Name:PARTNERS IN WOMEN'S HEALTH, P.C.
Entity Type:Organization
Organization Name:PARTNERS IN WOMEN'S HEALTH, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:W
Authorized Official - Last Name:IVCHENKO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-730-3331
Mailing Address - Street 1:2501 E SOUTHERN AVE
Mailing Address - Street 2:STE. 14
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-7669
Mailing Address - Country:US
Mailing Address - Phone:480-730-3331
Mailing Address - Fax:480-730-6340
Practice Address - Street 1:2501 E SOUTHERN AVE
Practice Address - Street 2:STE. 14
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7669
Practice Address - Country:US
Practice Address - Phone:480-730-3331
Practice Address - Fax:480-730-6340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ15906207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ292384Medicaid
AZ153833Medicaid
AZD00262Medicare UPIN
AZ153833Medicaid
AZWCLHV01Medicare ID - Type Unspecified
AZ292384Medicaid