Provider Demographics
NPI:1023148707
Name:CREEKWOOD WOMEN'S CARE, LLC
Entity type:Organization
Organization Name:CREEKWOOD WOMEN'S CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SALEH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:816-455-7400
Mailing Address - Street 1:200 NE 54TH ST
Mailing Address - Street 2:SUITE 111
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64118-4361
Mailing Address - Country:US
Mailing Address - Phone:816-455-7400
Mailing Address - Fax:816-455-7404
Practice Address - Street 1:200 NE 54TH ST
Practice Address - Street 2:SUITE 111
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64118-4361
Practice Address - Country:US
Practice Address - Phone:816-455-7400
Practice Address - Fax:816-455-7404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR8749207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOC51493Medicare UPIN