Provider Demographics
NPI:1881769545
Name:CLINTON WOMEN'S HEALTHCARE, PC
Entity type:Organization
Organization Name:CLINTON WOMEN'S HEALTHCARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:NADER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-726-6556
Mailing Address - Street 1:11051 HALL RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:UTICA
Mailing Address - State:MI
Mailing Address - Zip Code:48317-5735
Mailing Address - Country:US
Mailing Address - Phone:586-726-6556
Mailing Address - Fax:586-726-4917
Practice Address - Street 1:11051 HALL RD
Practice Address - Street 2:SUITE 110
Practice Address - City:UTICA
Practice Address - State:MI
Practice Address - Zip Code:48317-5735
Practice Address - Country:US
Practice Address - Phone:586-726-6556
Practice Address - Fax:586-726-4917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MION52820Medicare ID - Type UnspecifiedGROUP PROVIDER NUMBER