Provider Demographics
NPI:1356029953
Name:WINGWOMEN PLLC
Entity type:Organization
Organization Name:WINGWOMEN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PLLC MANAGEMENT COMPANY OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-767-6999
Mailing Address - Street 1:2185 JACQUELINE DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-4404
Mailing Address - Country:US
Mailing Address - Phone:415-767-6999
Mailing Address - Fax:
Practice Address - Street 1:423 W BROADWAY STE 302B
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02127-2266
Practice Address - Country:US
Practice Address - Phone:800-491-2142
Practice Address - Fax:800-540-1781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty