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GREAT LAKES OBSTETRIC GYNECOLOGICAL SPECIALISTS PLC NPI 1366478026


NPI Information

NPI: 1366478026
Provider Name: GREAT LAKES OBSTETRIC GYNECOLOGICAL SPECIALISTS PLC
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
1775 WELLS AVE
MUSKEGON, MI
ZIP 49442
Phone: (231) 773-9048
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GREAT LAKES OBSTETRIC GYNECOLOGICAL SPECIALISTS PLC is a specialist in Muskegon, MI. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. GREAT LAKES OBSTETRIC GYNECOLOGICAL SPECIALISTS PLC NPI is 1366478026. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1775 WELLS AVE
MUSKEGON, MI
ZIP 49442-459
Phone: (231) 773-9048
Fax: (231) 777-1218

The provider's authorized official is Mark T Karnes .
The authorized official title is Doctor and has the following contact phone number (231) 773-9048.

The enumeration date for this NPI number is 6/24/2006 and was last updated on 6/2/2009.


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
1174400000XSpecialistMK008760MICHIGANYes

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
1E26381MEDICARE UPINMICHIGAN
2433624011MEDICAIDMICHIGAN
3F04905MEDICARE UPINMICHIGAN
40N33710001MEDICARE ID-TYPE UNSPECIFIEDMICHIGAN
50N33710004MEDICARE ID-TYPE UNSPECIFIEDMICHIGAN
6H13079MEDICARE UPINMICHIGAN
70N33710005MEDICARE ID-TYPE UNSPECIFIEDMICHIGAN
80N33710002MEDICARE ID-TYPE UNSPECIFIEDMICHIGAN
9461890011MEDICAIDMICHIGAN
10F07598MEDICARE UPINMICHIGAN
11483147511MEDICAIDMICHIGAN
12433625011MEDICAIDMICHIGAN

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

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