Provider Demographics
NPI:1780739813
Name:INTERNATIONAL WOMENS HEALTH SERVICES PC
Entity type:Organization
Organization Name:INTERNATIONAL WOMENS HEALTH SERVICES PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:B
Authorized Official - Last Name:DOTT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-250-4447
Mailing Address - Street 1:993 JOHNSON FERRY RD NE # D
Mailing Address - Street 2:SUITE 360
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1620
Mailing Address - Country:US
Mailing Address - Phone:404-250-4447
Mailing Address - Fax:
Practice Address - Street 1:993 JOHNSON FERRY RD NE # D
Practice Address - Street 2:SUITE 360
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1620
Practice Address - Country:US
Practice Address - Phone:404-250-4447
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA176B00000X, 363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & GynecologyGroup - Multi-Specialty
No176B00000XOther Service ProvidersMidwifeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA300036100AMedicaid
GA300036100DMedicaid