Provider Demographics
NPI:1629046982
Name:WOMENS HEALTH ALLIANCE
Entity Type:Organization
Organization Name:WOMENS HEALTH ALLIANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRAC MGR
Authorized Official - Prefix:
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SMIRZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-814-4548
Mailing Address - Street 1:11725 ILLINOIS STREET
Mailing Address - Street 2:SUITE 350
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032
Mailing Address - Country:US
Mailing Address - Phone:317-814-4500
Mailing Address - Fax:317-814-4699
Practice Address - Street 1:11725 ILLINOIS STREET
Practice Address - Street 2:SUITE 350
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032
Practice Address - Country:US
Practice Address - Phone:317-814-4500
Practice Address - Fax:317-814-4699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-10
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN50000349A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN222120Medicare PIN