Provider Demographics
NPI:1285943845
Name:MIDWEST WOMEN OB/GYN, PLC
Entity type:Organization
Organization Name:MIDWEST WOMEN OB/GYN, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VEENA
Authorized Official - Middle Name:
Authorized Official - Last Name:KALRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-230-0492
Mailing Address - Street 1:2235 S LINDEN RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-5412
Mailing Address - Country:US
Mailing Address - Phone:810-230-0492
Mailing Address - Fax:
Practice Address - Street 1:2235 S LINDEN RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-5412
Practice Address - Country:US
Practice Address - Phone:248-515-2972
Practice Address - Fax:810-230-0640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-30
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301074926207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4716698Medicaid
MI0M28440Medicare PIN