Healthcare Provider Details

I. General information

NPI: 1598746067
Provider Name (Legal Business Name): OBGYN HEALTHCARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15185 ALLEN RD
SOUTHGATE MI
48195
US

IV. Provider business mailing address

15185 ALLEN RD
SOUTHGATE MI
48195
US

V. Phone/Fax

Practice location:
  • Phone: 734-281-3000
  • Fax: 734-284-1130
Mailing address:
  • Phone: 734-281-3000
  • Fax: 734-284-1130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number5101009581
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number4704100811
License Number StateMI

VIII. Authorized Official

Name: DENISE R SCHIEBOUT
Title or Position: PRESIDENT
Credential: DO
Phone: 734-281-3000