Healthcare Provider Details

I. General information

NPI: 1548497167
Provider Name (Legal Business Name): OB & GYN ASSOCIATE PHYSICIANS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2009
Last Update Date: 06/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2520 S. TELEGRAPH RD SUITE 200
BLOOMFIELD HILLS MI
48302-0302
US

IV. Provider business mailing address

2520 S. TELEGRAPH RD SUITE 200
BLOOMFIELD HILLS MI
48302-0302
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number4301081848
License Number StateMI

VIII. Authorized Official

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