Provider Demographics
NPI:1659526481
Name:WOMENS HEALTH FIRST PC
Entity Type:Organization
Organization Name:WOMENS HEALTH FIRST PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:M
Authorized Official - Last Name:DOHERTY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:269-945-8080
Mailing Address - Street 1:1108 W STATE ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:HASTINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49058-9711
Mailing Address - Country:US
Mailing Address - Phone:269-945-8080
Mailing Address - Fax:269-945-8081
Practice Address - Street 1:1108 W STATE ST
Practice Address - Street 2:SUITE 3
Practice Address - City:HASTINGS
Practice Address - State:MI
Practice Address - Zip Code:49058-9711
Practice Address - Country:US
Practice Address - Phone:269-945-8080
Practice Address - Fax:269-945-8081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-20
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MILD068172207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4210140Medicaid
MIH22115Medicare UPIN