Healthcare Provider Details
I. General information
NPI: 1003870999
Provider Name (Legal Business Name): WOMAN'S HEALTH ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/17/2006
Last Update Date: 08/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
322 US HIGHWAY 41 SUITE 202
SCHERERVILLE IN
46375-4203
US
IV. Provider business mailing address
9201 CALUMET AVE
MUNSTER IN
46321-2807
US
V. Phone/Fax
- Phone: 219-440-7025
- Fax:
- Phone: 219-836-2022
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HOWARD
MARCUS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 219-836-2022