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General NPI Number Information
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NPI Number | 1316270879
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Entity Type | Organization
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Legal Business Name | OBGYN WOMENS HEALTH CENTER, LLC
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Dates
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Enumeration Date | 09/15/2009
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Last Update Date | 08/03/2017
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Provider Practice Location Address
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Address Line | 1043 HARDING MEMORIAL PKWY
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City | MARION
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State | OH
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Zip | 43302-6315
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Country | US
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Telephone | 740-383-4090
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Fax | 740-383-2850
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Provider Business Mailing Address
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Address Line | 1043 HARDING MEMORIAL PKWY
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City | MARION
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State | OH
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Zip | 43302-6315
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Country | US
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Telephone | 740-383-4090
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Fax | 740-383-2850
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Authorized Official
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Title or Position | OWNER
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Name | DR. EMAD Y MOUSA
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Credential | M.D.
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Telephone | 740-383-4090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 35092078
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License Number State | OH
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