Healthcare Provider Details

I. General information

NPI: 1932420130
Provider Name (Legal Business Name): WOMENS MEDICAL SERVICES OF MUSKEGON P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2010
Last Update Date: 11/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

863 E APPLE AVE
MUSKEGON MI
49442-3737
US

IV. Provider business mailing address

863 E APPLE AVE
MUSKEGON MI
49442-3737
US

V. Phone/Fax

Practice location:
  • Phone: 231-773-7666
  • Fax:
Mailing address:
  • Phone: 231-773-7666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number4301044385
License Number StateMI

VIII. Authorized Official

Name: ROBERT L ALEXANDER
Title or Position: OWNER
Credential: M.D.
Phone: 231-773-7666