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General NPI Number Information
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NPI Number | 1841273232
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Entity Type | Organization
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Legal Business Name | WOMEN'S SPECIALIST OF NORTHWEST INDIANA, LLC
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Dates
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Enumeration Date | 11/21/2005
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Last Update Date | 01/13/2009
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Provider Practice Location Address
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Address Line | 3924-26 MAIN ST. SUITE 202
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City | EAST CHICAGO
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State | IN
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Zip | 46312
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Country | US
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Telephone | 219-397-2008
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Fax | 219-398-1339
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Provider Business Mailing Address
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Address Line | 3924-26 MAIN ST. SUITE 202
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City | EAST CHICAGO
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State | IN
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Zip | 46312
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Country | US
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Telephone | 219-397-2008
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Fax | 219-398-1339
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Authorized Official
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Title or Position | CEO
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Name | DR. KIMBERLY D. ARTHUR
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Credential | M.D.
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Telephone | 219-397-2008
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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 | 01036148A
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License Number State | IN
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