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General NPI Number Information
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NPI Number | 1952119315
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Entity Type | Organization
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Legal Business Name | MICHIGAN REPRODUCTIVE LABS PC
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Dates
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Enumeration Date | 12/18/2024
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Last Update Date | 03/28/2025
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Provider Practice Location Address
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Address Line | 14801 FARMINGTON RD
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City | LIVONIA
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State | MI
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Zip | 48154-5429
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Country | US
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Telephone | 313-444-0064
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Fax |
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Provider Business Mailing Address
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Address Line | 14801 FARMINGTON RD
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City | LIVONIA
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State | MI
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Zip | 48154-5429
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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 | OFFICE MANAGER
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Name | ALI BAZZI
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Credential |
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Telephone | 734-280-2600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 |
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Taxonomy #2
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Taxonomy Code | 207VE0102X
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Taxonomy Name | Reproductive Endocrinology Physician
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License Number |
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License Number State |
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