Provider Demographics
NPI:1801083548
Name:WOMENS HEALTH CARE ASSOCIATES, LTD
Entity type:Organization
Organization Name:WOMENS HEALTH CARE ASSOCIATES, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:NOLAN
Authorized Official - Last Name:HETZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:920-683-0321
Mailing Address - Street 1:304 N RAPIDS RD
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-3408
Mailing Address - Country:US
Mailing Address - Phone:920-683-0321
Mailing Address - Fax:920-683-9078
Practice Address - Street 1:304 N RAPIDS RD
Practice Address - Street 2:
Practice Address - City:MANITOWOC
Practice Address - State:WI
Practice Address - Zip Code:54220-3408
Practice Address - Country:US
Practice Address - Phone:920-683-0321
Practice Address - Fax:920-683-9078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-26
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI29141-020207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI000038255Medicare PIN