Provider Demographics
NPI:1205906658
Name:MIDLANDS WOMEN'S CARE, LLC
Entity type:Organization
Organization Name:MIDLANDS WOMEN'S CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEVIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:803-798-7660
Mailing Address - Street 1:3020 SUNSET BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-3494
Mailing Address - Country:US
Mailing Address - Phone:803-798-7660
Mailing Address - Fax:803-216-0388
Practice Address - Street 1:3020 SUNSET BLVD STE 105
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-3494
Practice Address - Country:US
Practice Address - Phone:803-798-7660
Practice Address - Fax:803-216-0388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP4578Medicaid
SC=========OtherEIN NUMBER
SC8678Medicare PIN