Healthcare Provider Details

I. General information

NPI: 1710166061
Provider Name (Legal Business Name): HURON VALLEY OBSTETRICS & GYNECOLOGY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2007
Last Update Date: 06/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8906 COMMERCE RD SUITE 3
COMMERCE TOWNSHIP MI
48382-4484
US

IV. Provider business mailing address

8906 COMMERCE RD SUITE 3
COMMERCE TOWNSHIP MI
48382-4484
US

V. Phone/Fax

Practice location:
  • Phone: 248-360-1770
  • Fax: 248-360-1950
Mailing address:
  • Phone: 248-360-1770
  • Fax: 248-360-1950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberJM007511
License Number StateMI

VIII. Authorized Official

Name: DR. JEFFREY MILLER
Title or Position: PHYSICIAN/OWNER
Credential: D.O.
Phone: 248-360-1770