Provider Demographics
NPI:1598834038
Name:WOMEN MEDICAL CENTER,PC
Entity Type:Organization
Organization Name:WOMEN MEDICAL CENTER,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARTINA
Authorized Official - Middle Name:LENORA
Authorized Official - Last Name:ABRAMS-ALDERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-841-3400
Mailing Address - Street 1:9724 DIX
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48120-1566
Mailing Address - Country:US
Mailing Address - Phone:313-841-3400
Mailing Address - Fax:313-841-6890
Practice Address - Street 1:9724 DIX
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48120-1566
Practice Address - Country:US
Practice Address - Phone:313-841-3400
Practice Address - Fax:313-841-6890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301407322207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2694395Medicaid
MI0826935OtherBLUE CROSS BLUE SHIELD
MI0826935OtherBLUE CROSS BLUE SHIELD
MI2694395Medicaid