Healthcare Provider Details

I. General information

NPI: 1265543318
Provider Name (Legal Business Name): OBSTETRICS & GYNECOLOGY ASSOCIATE PHYSICIANS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2520 S TELEGRAPH RD SUITE 200
BLOOMFIELD HILLS MI
48302-0285
US

IV. Provider business mailing address

2725 WARNER DR
W BLOOMFIELD MI
48324-2445
US

V. Phone/Fax

Practice location:
  • Phone: 248-335-9207
  • Fax: 248-335-2394
Mailing address:
  • Phone: 248-360-7797
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number430103648
License Number StateMI

VIII. Authorized Official

Name: DR. TELESFORO E GARCIA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 248-335-9207