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General NPI Number Information
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NPI Number | 1578767851
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Entity Type | Organization
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Legal Business Name | PARTNERS IN WOMEN'S HEALTH, P.C.
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Dates
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Enumeration Date | 06/12/2007
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Last Update Date | 04/12/2011
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Provider Practice Location Address
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Address Line | 2501 E SOUTHERN AVE STE. 14
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City | TEMPE
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State | AZ
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Zip | 85282-7669
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Country | US
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Telephone | 480-730-3331
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Fax | 480-730-6340
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Provider Business Mailing Address
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Address Line | 2501 E SOUTHERN AVE STE. 14
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City | TEMPE
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State | AZ
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Zip | 85282-7669
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Country | US
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Telephone | 480-730-3331
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Fax | 480-730-6340
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL W. IVCHENKO
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Credential | M.D.
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Telephone | 480-730-3331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 15906
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License Number State | AZ
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