Provider Demographics
NPI:1255747572
Name:LAFAYETTE WOMEN'S HEALTH PLC
Entity type:Organization
Organization Name:LAFAYETTE WOMEN'S HEALTH PLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EVON
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCHEXNAYDRE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:231-527-5207
Mailing Address - Street 1:7433 PALM DR
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:49456-9302
Mailing Address - Country:US
Mailing Address - Phone:231-527-5207
Mailing Address - Fax:
Practice Address - Street 1:953 SEMINOLE RD
Practice Address - Street 2:
Practice Address - City:NORTON SHORES
Practice Address - State:MI
Practice Address - Zip Code:49441-4341
Practice Address - Country:US
Practice Address - Phone:231-527-5207
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-08
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301075975207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty