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General NPI Number Information
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NPI Number | 1316114549
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Entity Type | Organization
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Legal Business Name | DR. T. FELLENBAUM M.D. & OB/GYN ASSOCIATES, P.C.
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Dates
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Enumeration Date | 05/16/2008
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 3500 CALKINS RD
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City | FLINT
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State | MI
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Zip | 48532-3500
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Country | US
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Telephone | 810-733-8200
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Fax | 810-221-1751
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Provider Business Mailing Address
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Address Line | 3500 CALKINS RD
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City | FLINT
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State | MI
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Zip | 48532-3500
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Country | US
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Telephone | 810-733-8200
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Fax | 810-221-1751
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MR. DONOVAN MISKE
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Credential |
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Telephone | 810-733-8200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 4301056913
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License Number State | MI
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