West Shore Womens Practice PC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

4301079496 Issued in MI

Legal business name

WEST SHORE WOMENS PRACTICE PC

Practice address

1293 E Parkdale Ave
Suite 1200a
Manistee, MI 49660-8904

Phone

(231) 398-0222

Fax

(231) 398-0225

NPI assigned

Dec 31, 2007

Last updated

Sep 11, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Marian R Fuller, M.D.NPI 1225053366

Title

Ceo

Phone

(231) 398-0222

Specialties & licenses 1

Addresses

Other identifiers 3

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Marian Fuller, MD

  • Obstetrics & Gynecology Physician
  • Manistee, MI
  • NPI 1225053366
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1199059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221091200000",
    "number": "1275718900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1293 E PARKDALE AVE",
            "address_2": "SUITE 1200A",
            "city": "MANISTEE",
            "state": "MI",
            "postal_code": "496608904",
            "telephone_number": "231-398-0222",
            "fax_number": "231-398-0225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1293 E PARKDALE AVE",
            "address_2": "SUITE 1200A",
            "city": "MANISTEE",
            "state": "MI",
            "postal_code": "496608904",
            "telephone_number": "231-398-0222",
            "fax_number": "231-398-0225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST SHORE WOMENS PRACTICE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-31",
        "last_updated": "2008-09-11",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "MARIAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "231-398-0222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301079496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK PIN",
            "identifier": "1605115302",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "MF079496",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "1605115302",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• West Shore Health Centers Corporation
• West Shore Health Centers Corporation (Robert Barry MD)
• West Shore Health Centers Corporation (Kevin Anderson, MD)
• West Shore Health Centers Corporation (Kevin Anderson MD)
• West Shore Health Centers Corporation (Edwardo Barlan MD)
• Western Michigan Apothecaries, Inc (The Apothecary Shoppe)
• Western Michigan ENT PC
• Daryl B Wever
• Carl Walter Wilberg, D.O.
• Russell G Williams, D.O.

• Obstetrics & Gynecology Physician in Manistee, MI
• Providers in Manistee, MI by specialty
• Obstetrics & Gynecology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.