# RENAISSANCE WOMENS CENTER, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124202262
- **Authorized official:** DR. DEBORAH LYNNE MCCULLOUGH MD (CEO/OWNER)
- **Authorized official phone:** (219) 887-7313

## Contact information

- **Practice address:** 6111 HARRISON ST, SUITE 255, MERRILLVILLE, IN 46410-2969
- **Practice address phone:** (773) 887-7313
- **Mailing address:** 6111 HARRISON ST, SUITE 255, MERRILLVILLE, IN 46410-2969
- **Mailing address phone:** (773) 887-7313

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 01026315A | IN | Yes |

## Other

- **Enumeration date:** 12/26/2007
- **Last updated:** 06/27/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000084532 | ANTHEM | IN |
| 05 | — | 100147650A | — | IN |