Provider Demographics
NPI:1306399068
Name:OBSTETRICS & GYNECOLOGY OF GREATER FLINT PC
Entity Type:Organization
Organization Name:OBSTETRICS & GYNECOLOGY OF GREATER FLINT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:KHEDR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-733-0010
Mailing Address - Street 1:1335 S LINDEN RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3420
Mailing Address - Country:US
Mailing Address - Phone:810-733-0010
Mailing Address - Fax:810-733-0011
Practice Address - Street 1:1335 S LINDEN RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3420
Practice Address - Country:US
Practice Address - Phone:810-733-0010
Practice Address - Fax:810-733-0011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-29
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301083799207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty