MEDICARE: BIRTH DETROIT INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QB0400X	Birthing Clinic/Center

General Provider Information

NPI Number	:	1275127565
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BIRTH DETROIT INC.

Provider Business Mailing Address
First Line	:	PO BOX 19727
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48219-0727
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8575 HERITAGE PL
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48204-2326
Country	:	US
Telephone Number	:	313-977-0962
Fax Number	:

Authorized Official
Title or Position	:	CHIEF CLINICAL OFFICER
Name	:	CHAR'LY RENEE SNOW
Credential	:
Telephone Number	:	313-326-2311

Provider Enumeration Date	:	02/26/2021
Last Update Date	:	04/11/2025

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Directions to “BIRTH DETROIT INC. ” Practice Location

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