Healthcare Provider Details

I. General information

NPI: 1134009707
Provider Name (Legal Business Name): MICHIGAN FERTILITY SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2025
Last Update Date: 09/04/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29255 NORTHWESTERN HWY STE 202
SOUTHFIELD MI
48034-5741
US

IV. Provider business mailing address

29255 NORTHWESTERN HWY STE 202
SOUTHFIELD MI
48034-5741
US

V. Phone/Fax

Practice location:
  • Phone: 248-301-9730
  • Fax: 248-905-3411
Mailing address:
  • Phone: 248-301-9730
  • Fax: 248-905-3411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. AWONIYI O AWONUGA
Title or Position: OWNER
Credential: MD
Phone: 248-301-9730