Healthcare Provider Details

I. General information

NPI: 1649206996
Provider Name (Legal Business Name): COMPLETE HEALTHCARE FOR WOMEN INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 07/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5888 CLEVELAND AVE
COLUMBUS OH
43231-2815
US

IV. Provider business mailing address

5888 CLEVELAND AVE
COLUMBUS OH
43231-2815
US

V. Phone/Fax

Practice location:
  • Phone: 614-882-4343
  • Fax: 614-882-4664
Mailing address:
  • Phone: 614-882-4343
  • Fax: 614-882-4664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number35-07-5146-S
License Number StateOH

VIII. Authorized Official

Name: DR. MILROY J. SAMUEL
Title or Position: OWNER
Credential: M.D.
Phone: 614-882-4343