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General NPI Number Information
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NPI Number | 1750361986
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Entity Type | Organization
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Legal Business Name | WOMAN'S WELLNESS CENTER, PC
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Dates
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Enumeration Date | 01/23/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2376 CYPRESS CIR SUITE 203
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City | CONWAY
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State | SC
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Zip | 29526-8964
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Country | US
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Telephone | 843-347-4660
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Fax | 843-347-6495
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Provider Business Mailing Address
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Address Line | 2376 CYPRESS CIR SUITE 203
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City | CONWAY
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State | SC
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Zip | 29526-8964
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Country | US
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Telephone | 843-347-4660
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Fax | 843-347-6495
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. VANESSA G NILES
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Credential | MD
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Telephone | 843-347-4600
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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 | 13889
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License Number State | SC
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