Basic Information
| Provider Information | |||||||||
| NPI: | 1780623637 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UNIVERSITY WOMEN'S CARE, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3750 WOODWARD AVE | ||||||||
| Address2: | STE 200A | ||||||||
| City: | DETROIT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 482012007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3139934513 | ||||||||
| FaxNumber: | 3139930689 | ||||||||
| Practice Location | |||||||||
| Address1: | 3750 WOODWARD AVE | ||||||||
| Address2: | STE 200B | ||||||||
| City: | DETROIT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 482012007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3139934538 | ||||||||
| FaxNumber: | 3139934537 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | MALONE | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
| AuthorizedOfficialMiddleName: | M. | ||||||||
| AuthorizedOfficialTitleorPosition: | CHAIRMAN | ||||||||
| AuthorizedOfficialTelephone: | 3139934513 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNameSuffix: | JR. | ||||||||
| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.