Provider Demographics
NPI:1841814936
Name:ADVANCED WOMEN'S CARE CENTER
Entity type:Organization
Organization Name:ADVANCED WOMEN'S CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TAMIKA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:SEA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-538-1723
Mailing Address - Street 1:290 COUNTRY CLUB DR STE 210
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-9022
Mailing Address - Country:US
Mailing Address - Phone:770-538-1723
Mailing Address - Fax:470-202-9820
Practice Address - Street 1:290 COUNTRY CLUB DR STE 210
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-9022
Practice Address - Country:US
Practice Address - Phone:901-283-1900
Practice Address - Fax:404-565-0243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-03
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty