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General NPI Number Information
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NPI Number | 1194806745
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Entity Type | Organization
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Legal Business Name | BICOUNTY MEDICAL PRACTICES
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 30205 SCHOENHERR RD STE B
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City | WARREN
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State | MI
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Zip | 48088-6800
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Country | US
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Telephone | 586-558-9966
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Fax | 586-558-5534
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Provider Business Mailing Address
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Address Line | 30205 SCHOENHERR RD STE B
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City | WARREN
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State | MI
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Zip | 48088-6800
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Country | US
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Telephone | 586-558-9966
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Fax | 586-558-5534
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | SUE COLOMINA
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Credential |
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Telephone | 586-558-5237
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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