Provider Demographics
NPI:1093983280
Name:HURON POINTE OB-GYN PC
Entity Type:Organization
Organization Name:HURON POINTE OB-GYN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:RITTEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-269-6900
Mailing Address - Street 1:PO BOX 306
Mailing Address - Street 2:
Mailing Address - City:BAD AXE
Mailing Address - State:MI
Mailing Address - Zip Code:48413-0306
Mailing Address - Country:US
Mailing Address - Phone:989-269-6900
Mailing Address - Fax:
Practice Address - Street 1:1176 1/2 S LAPEER RD
Practice Address - Street 2:SUITE C
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-3385
Practice Address - Country:US
Practice Address - Phone:989-269-6900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0C21014OtherBLUE CROSS BLUE SHIELD
MI0N27380Medicare PIN