GROSSE PTE OBSTETRICS & GYN PC NPI 1396812624

NPI Information

GROSSE PTE OBSTETRICS & GYN PC is a specialist in Roseville, 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. GROSSE PTE OBSTETRICS & GYN PC NPI is 1396812624. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Grosse Pointe Ob &gyn.

The provider's business location address is:

25910 KELLY RD
STE 9
ROSEVILLE, MI
ZIP 48066-466
Phone: (586) 779-6222
Fax: (586) 779-6228

The provider's authorized official is Grazyna Krystina Zajdel .
The authorized official title is Corporation President and has the following contact phone number (313) 882-6780.

The CLIA number assigned to this NPI record is 23D0858790 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 11/30/2006 and was last updated on 12/15/2009.

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:

Other Identifiers

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

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