MEDICARE: DAVINCII OBSTETRICS & GYNECOLOGY PLC

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	207V00000X	Obstetrics & Gynecology Physician

General Provider Information

NPI Number	:	1508928847
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVINCII OBSTETRICS & GYNECOLOGY PLC

Provider Business Mailing Address
First Line	:	1435 E 12 MILE RD
Second Line	:
City	:	MADISON HEIGHTS
State	:	MI
Zip	:	48071-2653
Country	:	US
Telephone Number	:	248-543-2229
Fax Number	:

Provider Business Practice Location Address
First Line	:	1435 E 12 MILE RD
Second Line	:
City	:	MADISON HEIGHTS
State	:	MI
Zip	:	48071-2653
Country	:	US
Telephone Number	:	248-543-2229
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JACQUELINE L TAYLOR
Credential	:	MD
Telephone Number	:	248-543-2229

Provider Enumeration Date	:	12/14/2006
Last Update Date	:	11/08/2019

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