Provider Demographics
NPI:1861706616
Name:WOMENS HEALTHCARE CONSULTANTS PC
Entity type:Organization
Organization Name:WOMENS HEALTHCARE CONSULTANTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JODIE
Authorized Official - Middle Name:
Authorized Official - Last Name:RAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-395-8192
Mailing Address - Street 1:3009 N BALLAS RD
Mailing Address - Street 2:SUITE 352 BUILDING C
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-2322
Mailing Address - Country:US
Mailing Address - Phone:314-395-8192
Mailing Address - Fax:314-395-8196
Practice Address - Street 1:3009 N BALLAS RD
Practice Address - Street 2:SUITE 352 BUILDING C
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2322
Practice Address - Country:US
Practice Address - Phone:314-395-8192
Practice Address - Fax:314-395-8196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-04
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO10176207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOF33891Medicare UPIN