Provider Demographics
NPI:1992895221
Name:COMPREHENSIVE WOMAN'S CARE, PC
Entity type:Organization
Organization Name:COMPREHENSIVE WOMAN'S CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:R
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-286-6060
Mailing Address - Street 1:39200 GARFIELD RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-4095
Mailing Address - Country:US
Mailing Address - Phone:586-286-6060
Mailing Address - Fax:586-286-5055
Practice Address - Street 1:39200 GARFIELD RD
Practice Address - Street 2:SUITE B
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48038-4095
Practice Address - Country:US
Practice Address - Phone:586-286-6060
Practice Address - Fax:586-286-5055
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EASTSIDE GYNECOLOGY-OBSTETRICS, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-16
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2942798Medicaid
MI160E078710OtherBCBS MI
MI1750415915OtherEASTSIDE GYNECOLOGY-OBSTETRICS, P.C.