Provider Demographics
NPI:1861554354
Name:COMPREHENSIVE OBGYN HEALTH CENTER
Entity type:Organization
Organization Name:COMPREHENSIVE OBGYN HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:BORQUAYE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:912-877-2228
Mailing Address - Street 1:455 S MAIN ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:HINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31313-4353
Mailing Address - Country:US
Mailing Address - Phone:912-877-2228
Mailing Address - Fax:912-877-2463
Practice Address - Street 1:455 S MAIN ST
Practice Address - Street 2:SUITE 202
Practice Address - City:HINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:31313-4353
Practice Address - Country:US
Practice Address - Phone:912-877-2228
Practice Address - Fax:912-877-2463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA=========OtherTAX ID NUMBER