Provider Demographics
NPI:1831379379
Name:PRADHAN CENTER FOR WOMEN PLC
Entity type:Organization
Organization Name:PRADHAN CENTER FOR WOMEN PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SEBEENA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRADHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:517-278-6929
Mailing Address - Street 1:49 CASS ST S
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49037-2331
Mailing Address - Country:US
Mailing Address - Phone:269-969-8920
Mailing Address - Fax:269-969-8921
Practice Address - Street 1:360 E CHICAGO ST
Practice Address - Street 2:SUITE I-109
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036-2086
Practice Address - Country:US
Practice Address - Phone:517-278-6929
Practice Address - Fax:517-278-1810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MISP066447207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P28050Medicare PIN