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General NPI Number Information
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NPI Number | 1306002704
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Entity Type | Organization
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Legal Business Name | ASCENSION MEDICAL GROUP MICHIGAN
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Dates
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Enumeration Date | 08/05/2008
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 11012 E 13 MILE RD SUITE 212
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City | WARREN
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State | MI
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Zip | 48093-2572
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Country | US
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Telephone | 586-582-7150
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Fax | 586-582-7164
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Provider Business Mailing Address
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Address Line | PO BOX 14129
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City | BELFAST
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State | ME
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Zip | 04915-4032
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | RACHEL R PERRY
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Credential |
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Telephone | 248-221-1918
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number |
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State | MI
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Taxonomy #3
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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 | MI
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