Provider Demographics
NPI:1750618278
Name:CARSON CITY CENTER FOR WOMEN'S HEALTHCARE, P.C.
Entity type:Organization
Organization Name:CARSON CITY CENTER FOR WOMEN'S HEALTHCARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:BECHER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:989-584-3107
Mailing Address - Street 1:PO BOX 670
Mailing Address - Street 2:401 E ELM ST
Mailing Address - City:CARSON CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48811-0670
Mailing Address - Country:US
Mailing Address - Phone:989-584-3107
Mailing Address - Fax:989-584-6458
Practice Address - Street 1:401 E ELM ST
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:MI
Practice Address - Zip Code:48811-0670
Practice Address - Country:US
Practice Address - Phone:989-584-3107
Practice Address - Fax:989-584-6458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-04
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI105177499Medicaid
MI114453149Medicaid
MI0N59470Medicare PIN