Provider Demographics
NPI:1336398684
Name:COMPREHENSIVE CARE FOR WOMEN OF THE MAHONING VALLEY, INC
Entity Type:Organization
Organization Name:COMPREHENSIVE CARE FOR WOMEN OF THE MAHONING VALLEY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:EMAD
Authorized Official - Middle Name:SHAWKY
Authorized Official - Last Name:BAKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-505-9581
Mailing Address - Street 1:1252 YOUNGSTOWN WARREN RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:NILES
Mailing Address - State:OH
Mailing Address - Zip Code:44446-4650
Mailing Address - Country:US
Mailing Address - Phone:330-505-9581
Mailing Address - Fax:
Practice Address - Street 1:1252 YOUNGSTOWN WARREN RD
Practice Address - Street 2:SUITE B
Practice Address - City:NILES
Practice Address - State:OH
Practice Address - Zip Code:44446-4650
Practice Address - Country:US
Practice Address - Phone:330-505-9581
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-11
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9381981Medicare PIN