MEDICARE: A WOMAN'S PLACE INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	35079037P	OH

General Provider Information

NPI Number	:	1881843175
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A WOMAN'S PLACE INC.

Provider Business Mailing Address
First Line	:	3000 REGENCY CT
Second Line	:	STE. 201
City	:	TOLEDO
State	:	OH
Zip	:	43623-3092
Country	:	US
Telephone Number	:	419-841-7190
Fax Number	:	419-841-9631

Provider Business Practice Location Address
First Line	:	3000 REGENCY CT
Second Line	:	STE. 201
City	:	TOLEDO
State	:	OH
Zip	:	43623-3092
Country	:	US
Telephone Number	:	419-841-7190
Fax Number	:	419-841-9631

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SUSAN ANN POHLOD-MILLER
Credential	:	M.D.
Telephone Number	:	419-841-7190

Provider Enumeration Date	:	09/11/2008
Last Update Date	:	09/11/2008

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