Provider Demographics
NPI:1346317674
Name:MICHIGAN OBSTETRICS AND GYNECOLOGY PC
Entity Type:Organization
Organization Name:MICHIGAN OBSTETRICS AND GYNECOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:LOWN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:616-532-5025
Mailing Address - Street 1:2221 HEALTH DR SW
Mailing Address - Street 2:SUITE 2100
Mailing Address - City:WYOMING
Mailing Address - State:MI
Mailing Address - Zip Code:49519
Mailing Address - Country:US
Mailing Address - Phone:616-532-5025
Mailing Address - Fax:
Practice Address - Street 1:2221 HEALTH DR SW
Practice Address - Street 2:SUITE 2100
Practice Address - City:WYOMING
Practice Address - State:MI
Practice Address - Zip Code:49519
Practice Address - Country:US
Practice Address - Phone:616-532-5025
Practice Address - Fax:616-532-6126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
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
MIOM61160Medicare ID - Type Unspecified