Healthcare Provider Details
I. General information
NPI: 1689841165
Provider Name (Legal Business Name): WOMEN'S MEDICAL CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/13/2008
Last Update Date: 05/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3630 WILLOWCREEK RD
PORTAGE IN
46368-5075
US
IV. Provider business mailing address
101 W 61ST AVE
HOBART IN
46342-6486
US
V. Phone/Fax
- Phone: 219-759-1389
- Fax: 219-759-3426
- Phone: 219-945-4965
- Fax: 219-947-1402
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 01053230A |
| License Number State | IN |
VIII. Authorized Official
Name: DR.
NAVIN
BAROT
Title or Position: DIRECTOR
Credential: M.D.
Phone: 219-947-3030