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DR. T. FELLENBAUM M.D. & OB/GYN ASSOCIATES P.C. NPI 1316114549


NPI Information

NPI: 1316114549
Provider Name: DR. T. FELLENBAUM M.D. & OB/GYN ASSOCIATES, P.C.

Doing Business As: MID-MICHIGAN VULVAR CARE AND COLPOSCOPY CENTER

Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Organization

CLIA Number: 23D1084811

Address:
4520 LINDEN CREEK PKWY
SUITE F
FLINT, MI
ZIP 48507
Phone: (810) 733-8200
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DR. T. FELLENBAUM M.D. & OB/GYN ASSOCIATES, P.C. is an obstetrics gynecology in Flint, MI. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. DR. T. FELLENBAUM M.D. & OB/GYN ASSOCIATES, P.C. NPI is 1316114549. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Mid-michigan Vulvar Care And Colposcopy Center.

The provider's business location address is:

4520 LINDEN CREEK PKWY
SUITE F
FLINT, MI
ZIP 48507-969
Phone: (810) 733-8200
Fax: (810) 733-8272

The provider's authorized official is Donovan Miske .
The authorized official title is Office Manager and has the following contact phone number (810) 733-8200.

The CLIA number assigned to this NPI record is 23D1084811 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 5/16/2008 and was last updated on 1/17/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207V00000XObstetrics & Gynecology4301056913MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11606365292OTHERMICHIGANHEALTH PLUS OF MICHIGAN PPO
21602513951OTHERMICHIGANBLUE CROSS BLUE SHIELD OF MICHIGAN PPO TRUST
31602513951OTHERMICHIGANBLUE CARE NETWORK (BCN) BLUE PREFERRED PLUS
41606365292OTHERMICHIGANHEALTH PLUS OF MICHIGAN COMMERCIAL
51606365292OTHERMICHIGANGENESEE HEALTH PLAN (GHP)
6F24353OTHERMICHIGANHEALTH ALLIANCE PLAN (HAP) PHP
71602513951OTHERMICHIGANBLUE CROSS BLUE SHIELD OF MICHIGAN ADVANTAGE
81602513951OTHERMICHIGANBLUE CARE NETWORK (BCN) BLUE CHOICE
9123042OTHERMICHIGANPREFERRED CHOICES
101606365292OTHERMICHIGANHEALTH PLUS OF MICHIGAN MEDICARE
111606365292OTHERMICHIGANHEALTH PLUS OF MICHIGAN (HGH) MEDICAID
121366457848OTHERMICHIGANMOLINA
13F24353OTHERMICHIGANHEALTH ALLIANCE PLAN (HAP) COMMERCIAL
141602513951OTHERMICHIGANBLUE CARE NETWORK (BCN) MEDICARE ADVANTAGE
151602513951OTHERMICHIGANBLUE CARE NETWORK (BCN) COMMERCIAL
161602513951OTHERMICHIGANBLUE CROSS BLUE SHIELD OF MICHIGAN TRADITIONAL
1715289OTHERMICHIGANHEALTH PLAN OF MICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.