Provider Demographics
NPI:1689877367
Name:ASSOCIATES IN OBSTETRICS GYNECOLOGY & INFERTILITY, PC
Entity Type:Organization
Organization Name:ASSOCIATES IN OBSTETRICS GYNECOLOGY & INFERTILITY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:M
Authorized Official - Last Name:HEGGEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:616-774-2400
Mailing Address - Street 1:545 MICHIGAN ST NE SUITE 300
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-5720
Mailing Address - Country:US
Mailing Address - Phone:616-774-2400
Mailing Address - Fax:616-774-8528
Practice Address - Street 1:545 MICHIGAN ST NE SUITE 300
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-5720
Practice Address - Country:US
Practice Address - Phone:616-774-2400
Practice Address - Fax:616-774-8528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes202C00000XAllopathic & Osteopathic PhysiciansIndependent Medical ExaminerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1487768693OtherNPI
MI1351566Medicaid
MI2665179Medicaid
MI1013023456OtherNPI
MI1821102013OtherNPI
MA4132151Medicaid
MI0M92640Medicare ID - Type Unspecified
MI1487768693OtherNPI
MI0410021Medicare ID - Type Unspecified
MI1821102013OtherNPI
MI1013023456OtherNPI
MIM92640Medicare UPIN