Provider Demographics
NPI:1225701881
Name:VIOS FERTILITY INSTITUTE MICHIGAN PLLC
Entity Type:Organization
Organization Name:VIOS FERTILITY INSTITUTE MICHIGAN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIR INS CRED & PAYOR CONTRACTS
Authorized Official - Prefix:
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-435-9036
Mailing Address - Street 1:26400 W 12 MILE RD STE 140
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1753
Mailing Address - Country:US
Mailing Address - Phone:866-658-8214
Mailing Address - Fax:
Practice Address - Street 1:26400 W 12 MILE RD STE 140
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1753
Practice Address - Country:US
Practice Address - Phone:866-658-8214
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-29
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty