Provider Demographics
NPI:1629446315
Name:WOMENS HEALTH ASSOCIATES PLLC
Entity Type:Organization
Organization Name:WOMENS HEALTH ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MONA
Authorized Official - Middle Name:
Authorized Official - Last Name:FAKIH
Authorized Official - Suffix:
Authorized Official - Credentials:DO,RPH, FACOOG
Authorized Official - Phone:313-277-0400
Mailing Address - Street 1:25150 FORD RD STE 110
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-3163
Mailing Address - Country:US
Mailing Address - Phone:132-840-8223
Mailing Address - Fax:
Practice Address - Street 1:25150 FORD RD STE 110
Practice Address - Street 2:
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48127-3163
Practice Address - Country:US
Practice Address - Phone:313-284-0822
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-11
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QP2300X, 374J00000X
MI4704267581367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty
No374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty