Provider Demographics
NPI:1689735334
Name:BAYVIEW OBGYN, P.C.
Entity Type:Organization
Organization Name:BAYVIEW OBGYN, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANGER
Authorized Official - Prefix:
Authorized Official - First Name:ELAYNE
Authorized Official - Middle Name:L
Authorized Official - Last Name:BEHLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-487-2260
Mailing Address - Street 1:560 W MITCHELL ST
Mailing Address - Street 2:STE 210
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-2275
Mailing Address - Country:US
Mailing Address - Phone:231-487-2340
Mailing Address - Fax:231-487-2115
Practice Address - Street 1:220 BURDETTE ST
Practice Address - Street 2:
Practice Address - City:SAINT IGNACE
Practice Address - State:MI
Practice Address - Zip Code:49781-1712
Practice Address - Country:US
Practice Address - Phone:231-487-2340
Practice Address - Fax:231-487-2115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-08-22
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
MI160B41011OtherBLUE CROSS BLUE SHIELD MI
MI20517OtherPRIORITY HEALTH GROUP
MI160B41011OtherBLUE CROSS BLUE SHIELD MI
MI160B41011OtherBLUE CROSS BLUE SHIELD MI