Healthcare Provider Details

I. General information

NPI: 1891803904
Provider Name (Legal Business Name): VALLEY OB GYN CLINIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2006
Last Update Date: 11/27/2024
Certification Date: 11/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

926 N MICHIGAN AVE
SAGINAW MI
48602-4323
US

IV. Provider business mailing address

926 N MICHIGAN AVE
SAGINAW MI
48602-4323
US

V. Phone/Fax

Practice location:
  • Phone: 989-753-8453
  • Fax: 989-753-3519
Mailing address:
  • Phone: 989-753-8453
  • Fax: 989-753-3519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: TRISHA BUDA
Title or Position: BILLING SUPERVISOR
Credential:
Phone: 989-753-8453