Organization
PREMIER WOMENS CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. INDIRA NANNAPANENI M.D. (PHYSICIAN)
(330) 834-4000
Entity
Organization
Contact information
Practice address
2606 WALES AVE NW, SUITE 100, MASSILLON, OH 44646-2340
(330) 834-4000
Mailing address
2606 WALES AVE NW, SUITE 100, MASSILLON, OH 44646-2340
(330) 834-4000
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
35-07-7887 N
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2185291
—
OH
01
—
PR9344061
MEDICARE GROUP ID
OH
Enumeration date
05/24/2006
Last updated
07/26/2012
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