Provider Type Icon

RIVERSIDE OB GYN P C NPI 1699724559


NPI Information

NPI: 1699724559
Provider Name: RIVERSIDE OB GYN P C
Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Organization

CLIA Number: 23D0368687

Address:
2275 W JEFFERSON AVE
TRENTON, MI
ZIP 48183
Phone: (734) 675-7210
Get Directions

RIVERSIDE OB GYN P C is an obstetrics gynecology in Trenton, 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. RIVERSIDE OB GYN P C NPI is 1699724559. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

2275 W JEFFERSON AVE
TRENTON, MI
ZIP 48183-114
Phone: (734) 675-7210
Fax: (734) 675-3023

The provider's authorized official is Ahmad I. Al-jerdi .
The authorized official title is President and has the following contact phone number (734) 675-7210.

The CLIA number assigned to this NPI record is 23D0368687 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/9/2006 and was last updated on 6/26/2012.


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 & GynecologyYes

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
1=========OTHERMICHIGANUNITED HEALTHCARE
2H42769MEDICARE UPINMICHIGAN
32966851OTHERMICHIGANCIGNA
4160003353OTHERMICHIGANRAILROAD MEDICARE
54165045-10MEDICAIDMICHIGAN
60M84380MEDICARE PINMICHIGAN
71540358-11MEDICAIDMICHIGAN
86676861OTHERMICHIGANCIGNA
9160H210680OTHERMICHIGANBCBS
10160055737OTHERMICHIGANRAILROAD MEDICARE
11=========OTHERMICHIGANBCE EMERGIS
12=========OTHERMICHIGANPPOM
13160059461OTHERMICHIGANRAILROAD MEDICARE
144106545-11MEDICAIDMICHIGAN
154471183-11MEDICAIDMICHIGAN
167139017OTHERMICHIGANCIGNA
17160055739OTHERMICHIGANRAILROAD MEDICARE
180G24657MEDICARE PINMICHIGAN

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.