Provider Demographics
NPI:1780623637
Name:UNIVERSITY WOMEN'S CARE, INC
Entity type:Organization
Organization Name:UNIVERSITY WOMEN'S CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:MALONE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:313-993-4513
Mailing Address - Street 1:3750 WOODWARD AVE
Mailing Address - Street 2:STE 200A
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201-2007
Mailing Address - Country:US
Mailing Address - Phone:313-993-4513
Mailing Address - Fax:313-993-0689
Practice Address - Street 1:3750 WOODWARD AVE
Practice Address - Street 2:STE 200B
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2007
Practice Address - Country:US
Practice Address - Phone:313-993-4538
Practice Address - Fax:313-993-4537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0M57010Medicare ID - Type Unspecified