Healthcare Provider Details

I. General information

NPI: 1952119307
Provider Name (Legal Business Name): MICHIGAN FERTILITY INSTITUTE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2024
Last Update Date: 03/28/2025
Certification Date: 03/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14801 FARMINGTON RD
LIVONIA MI
48154-5429
US

IV. Provider business mailing address

14801 FARMINGTON RD
LIVONIA MI
48154-5429
US

V. Phone/Fax

Practice location:
  • Phone: 313-444-0064
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number
License Number State

VIII. Authorized Official

Name: ALI BAZZI
Title or Position: OFFICE MANAGER
Credential:
Phone: 734-280-2600