Provider Demographics
NPI:1548434814
Name:WOMANSAFEHEALTH
Entity type:Organization
Organization Name:WOMANSAFEHEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:SHADIGIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-477-5100
Mailing Address - Street 1:2340 E STADIUM BLVD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-4823
Mailing Address - Country:US
Mailing Address - Phone:734-477-5100
Mailing Address - Fax:734-477-5111
Practice Address - Street 1:2340 E STADIUM BLVD
Practice Address - Street 2:SUITE 8
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-4823
Practice Address - Country:US
Practice Address - Phone:734-477-5100
Practice Address - Fax:734-477-5111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301064081261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3139819Medicaid