Provider Demographics
NPI:1871626705
Name:COMPLETE CARE FOR WOMEN, P.C.
Entity type:Organization
Organization Name:COMPLETE CARE FOR WOMEN, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MINDY
Authorized Official - Middle Name:I
Authorized Official - Last Name:FINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-435-7755
Mailing Address - Street 1:1675 CUMBERLAND PKWY SE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-6359
Mailing Address - Country:US
Mailing Address - Phone:770-435-7755
Mailing Address - Fax:770-435-7911
Practice Address - Street 1:1675 CUMBERLAND PKWY SE
Practice Address - Street 2:SUITE 106
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-6359
Practice Address - Country:US
Practice Address - Phone:770-435-7755
Practice Address - Fax:770-435-7911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA032382174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAE86762Medicare UPIN
GA16BBCNQMedicare ID - Type Unspecified