Provider Demographics
NPI:1407895469
Name:ASSOCIATED OBSTETRICS & GYNECOLOGY, P.C.
Entity Type:Organization
Organization Name:ASSOCIATED OBSTETRICS & GYNECOLOGY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACRICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-338-0100
Mailing Address - Street 1:2525 S TELEGRAPH RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-0286
Mailing Address - Country:US
Mailing Address - Phone:248-338-0100
Mailing Address - Fax:248-977-3014
Practice Address - Street 1:2525 S TELEGRAPH RD
Practice Address - Street 2:SUITE 201
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-0286
Practice Address - Country:US
Practice Address - Phone:248-338-0100
Practice Address - Fax:248-977-3014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-05
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI160F36364OtherBCBS OF MICHIGAN GROUP
MI5101013679OtherPATRICIA KONDRATENKO, DO
MI5101016558OtherLISA HELMICK, DO
MI4301063928OtherPAUL CORSI, MD
MI4704224123OtherJULIE BILLIS FNP-BC
MI4301502068OtherASHLEE O'SHELL, MD
MI1790725984OtherDR. KONDRATENKO NPI