Provider Demographics
NPI:1053331876
Name:ALPENA OB-GYN PC
Entity Type:Organization
Organization Name:ALPENA OB-GYN PC
Other - Org Name:WOMENS HEALTH CENTER OF ALPENA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:D
Authorized Official - Last Name:BATES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-356-0504
Mailing Address - Street 1:109 W FLETCHER ST
Mailing Address - Street 2:
Mailing Address - City:ALPENA
Mailing Address - State:MI
Mailing Address - Zip Code:49707-2301
Mailing Address - Country:US
Mailing Address - Phone:989-354-0845
Mailing Address - Fax:989-354-2965
Practice Address - Street 1:393 LONG RAPIDS ROAD
Practice Address - Street 2:
Practice Address - City:ALPENA
Practice Address - State:MI
Practice Address - Zip Code:49707-1317
Practice Address - Country:US
Practice Address - Phone:989-354-0504
Practice Address - Fax:989-356-6981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI=========OtherTAX ID #