Provider Demographics
NPI:1427062496
Name:MEADOWBROOK WOMEN'S CLINIC, PA
Entity type:Organization
Organization Name:MEADOWBROOK WOMEN'S CLINIC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:H
Authorized Official - Last Name:KRAVITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:612-376-7708
Mailing Address - Street 1:825 S 8TH ST
Mailing Address - Street 2:SUITE 1018
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-1208
Mailing Address - Country:US
Mailing Address - Phone:612-376-7708
Mailing Address - Fax:612-376-9665
Practice Address - Street 1:825 S 8TH ST
Practice Address - Street 2:SUITE 1018
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-1208
Practice Address - Country:US
Practice Address - Phone:612-376-7708
Practice Address - Fax:612-376-9665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center