Healthcare Provider Details
I. General information
NPI: 1629446315
Provider Name (Legal Business Name): WOMENS HEALTH ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/11/2015
Last Update Date: 10/21/2024
Certification Date: 10/21/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
25150 FORD RD STE 110
DEARBORN HEIGHTS MI
48127-3163
US
IV. Provider business mailing address
25150 FORD RD STE 110
DEARBORN HEIGHTS MI
48127-3163
US
V. Phone/Fax
- Phone: 313-284-0822
- Fax:
- Phone: 132-840-8223
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 374J00000X |
| Taxonomy | Doula |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VX0000X |
| Taxonomy | Obstetrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MONA
FAKIH
Title or Position: SOLE MEMBER
Credential: DO,RPH, F.A.C.O.O.G
Phone: 313-277-0400