=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881843175
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | A WOMAN'S PLACE INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/11/2008
-----------------------------------------------------
Last Update Date | 09/11/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3000 REGENCY CT STE. 201
-----------------------------------------------------
City | TOLEDO
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43623-3092
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 419-841-7190
-----------------------------------------------------
Fax | 419-841-9631
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3000 REGENCY CT STE. 201
-----------------------------------------------------
City | TOLEDO
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43623-3092
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 419-841-7190
-----------------------------------------------------
Fax | 419-841-9631
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. SUSAN ANN POHLOD-MILLER
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 419-841-7190
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | 35079037P
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------