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General NPI Number Information
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NPI Number | 1003479288
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Entity Type | Organization
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Legal Business Name | ADVANCED WOMENS HEALTH AND SURGERY LLC
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Dates
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Enumeration Date | 04/15/2019
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Last Update Date | 04/15/2019
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Provider Practice Location Address
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Address Line | 25200 CENTER RIDGE RD
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City | WESTLAKE
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State | OH
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Zip | 44145-4141
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Country | US
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Telephone | 216-296-0458
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 314
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City | CHAGRIN FALLS
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State | OH
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Zip | 44022-0314
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HABIBEH GITIFOROOZ
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Credential | MD
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Telephone | 216-296-0458
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State |
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