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NPI Code Detail

MEDICARE: ADVANCED GYNECOLOGY AND OBSTETRICS, PLC

MEDICARE: ADVANCED GYNECOLOGY AND OBSTETRICS, 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
1207V00000XObstetrics & Gynecology Physician

General Provider Information

NPI Number : 1548439755
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANCED GYNECOLOGY AND OBSTETRICS, PLC
Provider Business Mailing Address
First Line : PO BOX 1608
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49501-1608
Country : US
Telephone Number : 800-968-6866
Fax Number : 616-532-7230
Provider Business Practice Location Address
First Line : 3238 CAPITAL AVE SW
Second Line :
City : BATTLE CREEK
State : MI
Zip : 49015-4302
Country : US
Telephone Number : 800-968-6866
Fax Number :
Authorized Official
Title or Position : PRESIDENT/PHYSICIAN
Name : BRIAN KRAUSS
Credential : M.D.
Telephone Number : 269-979-6432
Provider Enumeration Date : 02/22/2008
Last Update Date : 06/25/2010

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