Provider Demographics
NPI:1336105493
Name:CAPE CARE FOR WOMEN, LLC
Entity Type:Organization
Organization Name:CAPE CARE FOR WOMEN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DIANNE
Authorized Official - Middle Name:S
Authorized Official - Last Name:WOOLARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:573-339-1166
Mailing Address - Street 1:150 S MOUNT AUBURN RD
Mailing Address - Street 2:SUITE 318
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63703-4911
Mailing Address - Country:US
Mailing Address - Phone:573-339-1166
Mailing Address - Fax:573-339-7166
Practice Address - Street 1:150 S MOUNT AUBURN RD
Practice Address - Street 2:SUITE 318
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703-4910
Practice Address - Country:US
Practice Address - Phone:573-339-1166
Practice Address - Fax:573-339-7166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-25
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR2D86207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty