# MED SPA WOMANS HEALTHCARE

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

## Provider details

- **NPI number:** 1558309492
- **Authorized official:** MS. KAREN NICOLE LONG (INSURANCE ADMINISTRATOR CO-OFFICE)
- **Authorized official phone:** (219) 362-4690

## Contact information

- **Practice address:** 220 DUNES PLAZA, MICHIGAN CITY, IN 46360
- **Practice address phone:** (219) 879-6262
- **Practice address fax:** (219) 362-4692
- **Mailing address:** PO BOX 9721, MICHIGAN CITY, IN 46361
- **Mailing address phone:** (219) 362-4690
- **Mailing address fax:** (219) 362-4692

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 01052711A | IN | Yes |

## Other

- **Enumeration date:** 06/03/2006
- **Last updated:** 08/22/2020