Healthcare Provider Details
I. General information
NPI: 1871684761
Provider Name (Legal Business Name): GREAT LAKES BAY HEALTH CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/27/2006
Last Update Date: 09/02/2025
Certification Date: 03/11/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
501 LAPEER
SAGINAW MI
48607-1208
US
IV. Provider business mailing address
501 LAPEER
SAGINAW MI
48607-1208
US
V. Phone/Fax
- Phone: 989-759-6464
- Fax: 989-399-8233
- Phone: 989-759-6464
- Fax: 989-399-8233
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LISA
GALONSKA
Title or Position: VICE PRESIDENT
Credential:
Phone: 989-759-6464